Search

Pituitary adenylyl cyclase-activating polypeptide (PACAP) is a bioactive peptide with diverse effects in the nervous system. The present study investigated whether stimulation of PACAP receptors (PACAPRs) induces responses in neurons and satellite cells of the superior cervical ganglia (SCG), with special reference to intracellular Ca2+ ([Ca2+]i) changes. The expression of PACAPRs in SCG was detected by reverse transcription-PCR. PACAP type 1 receptor (PAC1R), vasoactive intestinal peptide receptor type (VPAC)1R, and VPAC2R transcripts were expressed in SCG, with PAC1R showing the highest levels. Confocal microscopy analysis revealed that PACAP38 and PACAP27 induced an increase in [Ca2+]i in SCG, first in satellite cells and subsequently in neurons. Neither extracellular Ca2+ removal nor Ca2+ channel blockade affected the PACAP38-induced increase in [Ca2+]i in satellite cells; however, this was partly inhibited in neurons. U73122 or xestospongin C treatment completely and partly abrogated [Ca2+]i changes in satellite cells and in neurons, respectively, whereas VPAC1R and VPAC2R agonists increased [Ca2+]i in satellite cells only. This is the first report demonstrating the expression of PACAPRs specifically, VPAC1 and VPAC2 in SCG and providing evidence for PACAP38-induced [Ca2+]i changes in both satellite cells and neurons via Ca2+ mobilization.

Adenosine 5'-triphosphate (ATP) can act as an extracellular signal that regulates various cellular functions. The present study aimed to determine which purinoceptors play a role in ATP-induced changes in intracellular Ca(2+) ([Ca(2+)]i) and amylase secretion in mouse parotid glands. ATP induced a steep increase in [Ca(2+)]i in acinar cells. The removal of extracellular Ca(2+) or the use of Ca(2+) channel blockers slightly inhibited this increase. Inhibition of PLCγ by U73122 and of IP3 by xestospongin C did not completely block this increase. The purinoceptor antagonists suramin and reactive blue-2 strongly inhibited the ATP-induced changes in [Ca(2+)]i. 2-MeSATP induced a strong increase in [Ca(2+)]i, while Bz-ATP induced a small [Ca(2+)]i increase, and UTP and α,β-MeATP had no effect. The potency order of ATP analogs (2-MeSATP > ATP >> UTP) suggested that P2Y1 and P2Y12 play a significant role in the cellular response to ATP. RT-PCR revealed that P2X2,4,7 and P2Y1,2,10,12,14 were expressed in acinar cells. Ca(2+)-dependent exocytotic secretion of amylase was detected in parotid glands. These findings indicated that ATP activates P2Y receptors more than P2X receptors at low concentrations. Thus, P2Y receptors were found to be the main receptors involved in Ca(2+)-related cell homeostasis and amylase secretion in mouse parotid glands.

Objective. The aim of this study was to evaluate the arterial to end-tidal partial pressure gradient of carbon dioxide according to age in the supine position during general anesthesia. Methods. From January 2001 to December 2013, we evaluated 596 patients aged ≥16 years who underwent general anesthesia in the supine position. The anesthetic charts of these 596 patients, all classified as American Society of Anesthesiologists physical status I or II, were retrospectively reviewed to investigate the accuracy of PaCO2 and ETCO2. Results. The a-ETCO2 was 3.0 ± 2.1 mmHg for patients aged 16 to 4.1±3.1 mmHg for patients ≥65 years. The a-ETCO2 was 2.4±3.1 mmHg for patients aged 16 to 25 years, 3.1±2.2 mmHg for patients aged 26 to 35 years, 3.0±2.2 mmHg for patients aged 36 to 45 years, 3.4±2.0 mmHg for patients aged 46 to 55 years, 3.2±2.0 mmHg for patients aged 56 to 64 years, 4.3±3.2 mmHg for patients aged 65 to 74 years, and 3.7±2.8 mmHg for patients aged 75 to 84 years. Conclusion. The arterial to end-tidal partial pressure gradient of carbon dioxide tended to increase with increasing age.

Lidocaine has a biphasic action on smooth muscle of peripheral blood vessels, with vasoconstriction at low concentrations and vasodilation at higher concentrations. Many in vivo studies have demonstrated the effects of lidocaine on aortic or coronary arteries in several animals, but there are few reports about the effect on peripheral vessels. This study was designed to investigate the direct effects of lidocaine on peripheral vessels, namely swine lingual and pulmonary arterial rings.Swine lingual artery and pulmonary artery segments, about 2-3 mm in diameter, were cut into 3-mm-long rings, and the lumen surface was gently rubbed to remove the endothelium. Isometric tension was measured using a displacement transducer and recorded. After a stable constriction was developed with 5 µM noradrenaline, 5 µM noradrenaline containing lidocaine (0.5, 1.0, 10, 20, 50 or 100 µg/ml) was perfused for 5 min, and then all drug perfusion was stopped. The strength of any isometric tension during an experiment was normalized to the strength of the isometric tension immediately before lidocaine perfusion, and expressed as a percentage.Lidocaine elicited a concentration-dependent biphasic response of lingual and pulmonary arterial rings. The lidocaine concentration at 1 µg/ml caused mild contraction. Dilation occurred at 10 µg/ml and increased with increasing dose.Lidocaine-induced vasoconstriction of swine lingual and pulmonary smooth muscle may occur at low concentration when lidocaine is infiltrated into the oral submucosa or administered intravenously for the treatment of ventricular arrhythmia.

Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in obese patients during general anesthesia. Materials and Methods: From January 2003 to December 2013, we studied 601 patients aged 16 years old or over undergoing general anesthesia. Patients had American Society of Anesthesiology physical status I and II and we reviewed their anesthetic charts. The P(a-ET)CO2 with respect to the BKI divided patients into two groups: 16 to < 65 years old, and ≥ 65 years old, and compared the P(a-ET)CO2 values between the two groups. Results: In patients aged 16 to < 65 years old, the mean P(a-ET)CO2 was 2.2 ± 3.1 mmHg at BKI < 20%; 3.3 ± 3.1 mmHg at 20% < BKI < 40%; and 5.5 ± 5.0 mmHg at 40% < BKI < 60%. In patients aged ≥ 65 years old , the mean P(a-ET)CO2 was 3.2 ± 4.1 mmHg at BKI < 20%; 4.3 ± 3.6 mmHg at 20% to < 40%; and 4.4 ± 3.3 mmHg at 40% to < 60%. Conclusion: The P(a-ET)CO2 tends to increase in obese patients during general anesthesia with increasing BKI in patients aged 16 to < 65 years old.

Pituitary adenylyl cyclase-activating polypeptide (PACAP) is a bioactive peptide with diverse effects in the nervous system. The present study investigated whether stimulation of PACAP receptors (PACAPRs) induces responses in neurons and satellite cells of the superior cervical ganglia (SCG), with special reference to intracellular Ca

Adenosine 5'-triphosphate (ATP) can act as an extracellular signal that regulates various cellular functions. The present study aimed to determine which purinoceptors play a role in ATP-induced changes in intracellular Ca(2+) ([Ca(2+)]i) and amylase secretion in mouse parotid glands. ATP induced a steep increase in [Ca(2+)]i in acinar cells. The removal of extracellular Ca(2+) or the use of Ca(2+) channel blockers slightly inhibited this increase. Inhibition of PLCγ by U73122 and of IP3 by xestospongin C did not completely block this increase. The purinoceptor antagonists suramin and reactive blue-2 strongly inhibited the ATP-induced changes in [Ca(2+)]i. 2-MeSATP induced a strong increase in [Ca(2+)]i, while Bz-ATP induced a small [Ca(2+)]i increase, and UTP and α,β-MeATP had no effect. The potency order of ATP analogs (2-MeSATPATPUTP) suggested that P2Y1 and P2Y12 play a significant role in the cellular response to ATP. RT-PCR revealed that P2X2,4,7 and P2Y1,2,10,12,14 were expressed in acinar cells. Ca(2+)-dependent exocytotic secretion of amylase was detected in parotid glands. These findings indicated that ATP activates P2Y receptors more than P2X receptors at low concentrations. Thus, P2Y receptors were found to be the main receptors involved in Ca(2+)-related cell homeostasis and amylase secretion in mouse parotid glands.

Measurement of end-tidal carbon dioxide (PETCO2) is useful because of its noninvasiveness, continuity, and response time when sudden changes in ventilation occur during inhalation sedation. We compared the accuracy of PETCO2 using a nasal mask and nasal cannula with the accuracy of transcutaneous carbon dioxide (TC-CO2) and determined which method is more useful during inhalation sedation in volunteers. We used a modified nasal mask (MNM) and modified nasal cannula (MNC) for measurement of PETCO2. The capnometer measured PETCO2 in the gas expired from the nasal cavity by means of two devices. The volunteers received supplemental O2 by means of each device at a flow rate of 6 L/min. After the volunteers lay quietly for 5 min with a supply of 100 % O2, they received supplemental N2O by means of each device at concentrations of 10, 20, and 25 % for 5 min and 30 % for 25 min. The correlation coefficient was poorer in the MNM than in the MNC, and the mean difference between TC-CO2 and PETCO2 in the MNM was greater than that in the MNC. The difference between the TC-CO2 and PETCO2 ranged from 3 to 6 mmHg in the MNM and from 2 to 5 mmHg in the MNC. The difference between two variables against the TC-CO2 and the CO2 waveforms obtained by means of the two devices were within the clinically acceptable range. Our two devices can provide continuous monitoring of PETCO2 with a supply of N2O/O2 in patients undergoing inhalation sedation.

We analyzed 25 cases of propofol(PPF) anesthesia using a laryngeal mask airway (LMA) in order to establish a method of safe outpatient anesthesia for the dental treatment of the handicapped. Subjects discussed here are gender, age, coexisting problems, medication, reasons for general anesthesia, dental treatments, the time needed to treat, general assessment, premedication, induction techniques, dosage of midazolam, dosage of PPF, the stability of airway management with LMA, infusion volume, body temperature under anesthesia, anesthesia period, period of time from stopping propofol till discharge, and states of patients after discharge. Results were that 1) airway management with LMA was secure in 76% of cases(19/25); 2) mean time from stopping propofol untill discharge was 70.8±16.3 minutes; 3) no problems occurred after discharge; 4) patient's helpers preferred outpatient anesthesia with short postoperative period of time. We conclude that 1) the airway management with LMA is non-invasive and reliable if gastric contents are removed; 2) PPF is suitable for outpatient anesthesia because fewer post-anesthetic problems occur than with sevoflurane; 3) anesthesia with FLMA and PPF is suitable for outpatients in dentistry not adjusted to admission.

Objective: During intravenous sedation, end-tidal carbon dioxide (ETCO2) is usually measured with a nasal cannula or mouth-nose cannula. We compared the measurement accuracy of ETCO2 between these two devices and TC-CO2 and assessed which device is more useful during intravenous sedation in volunteers. Methods: Eight male volunteers aged 25 to 35 years were evaluated in this single-institution blinded observational trial. After they lay quietly for 5 min without supplemental oxygen, the volunteers received supplemental oxygen by means of each device at a flow rate of 3 L/min for 15 min. Next, midazolam (0.05 mg/kg) was intravenously injected, flumazenil (20 mg) was injected 30 min later, and the ETCO2 and TC-CO2 waveform were recorded. Results: The differences between ETCO2 and TC-CO2 significantly increased after midazolam injection and decreased after flumazenil injection. The difference between ETCO2 and TC-CO2 using the nasal cannula was greater than that using the mouth-nose cannula. The mean difference between TC-CO2 and ETCO2 ranged from 3 to 9 mmHg after midazolam injection using a nasal mask, and the mean difference ranged from 3 to 6 mmHg after midazolam injection using a mouth-nose cannula. Conclusions: The difference between ETCO2 and TC-CO2 against TC-CO2 was within the clinically acceptable range. Both the nasal and mouth-nose cannula were useful for ETCO2 measurement with supplemental oxygen by means of each device at flow rate of 3 L/min during intravenous sedation in volunteers.

We investigated the features of swine lingual artery contraction induced with different strengths of stimulation. Endothelium-denuded artery rings were contracted with two concentrations of KCl, noradrenaline, and histamine with or without Y-27632, sodium nitroprusside (SNP), 2,2-diphenyl-1,3,2-oxaza-borolidine internal salt (2- APB), and extracellular Ca2+. While stored at 5 degrees C up to 3 days, artery rings remained active to strong stimulation but became inactive to weak stimulation if prior warming was lacking. Artery rings contracted slowly and progressively to weak stimulation but rapidly to strong stimulation and then kept a plateau or slightly relaxed. Y-27632, SNP, and 2-APB, irrespective of extracellular Ca2+, attenuated weak-stimulation-induced contractions to much greater extents except that 2-APB similarly diminished contractions to both noradrenaline concentrations. Without extracellular Ca2+, transitory contractions occurred with one peak to strong stimulation and two small peaks to weak stimulation, though one full peak to both noradrenaline concentrations. Artery rings lost stimulant responsiveness when extracellular Ca2+ was absent, but subsequent Ca2+ reintroduction without coexisting stimulant triggered transient contractions, which were as large as contractions to weak stimulation with extracellular Ca2+ and ceased with Y-27632, SNP, and 2-APB. These results collectively suggest that, in the lingual artery, its contraction properties shift coupling with strengths of both receptor- and voltage-mediated stimulation, with the tonic-like component being dominant in weak-stimulation-induced contraction.

One large hemangioma of the lower lip was resected by Nd-YAG laser of noncontact type in combination with intratumoral ligation. The operative procedure was safely performed at one time and the tumor disappeared completely in a short time. After 4 months follow-up period, the wound was completely healed and resulted in less scar formation and post-operative deformity and dysfunction. This patient is now in a good condition and shows no evidence of tumor recurrence.

tape, and reinforced with a mouth prop in order to keep it in the proper place (Fig. 1A). Pushing the tube with a finger into the oral vestibule and the retrodental space opposite to the treatment site would make it possible to examine and transfer the patient’s occlusion (Fig. 1B). Because of the flexibility of the tube, either dislodgement of the mask part or obstruction of the tube part could occur. Therefore, vigorous monitoring with capnography throughout the treatment will be required. Packing gauze into the pharynx can prevent the dislodgement of the mask part.

IMPLICATIONS Pulse oximetry is now considered essential for anesthetic management. We treated a patient with hemoglobin M(Iwate), a rare inheritable hemoglobinopathy rendering pulse oximetry completely useless because of its anomalous absorption spectrum.

A combination therapy was carried out that used antitumor agents with or without irradiation and surgery for 30 squamous cell carcinomas of the lower alveolus and gingiva during 1975-4986. Therapeutic results of a 5-year accumulative survival rate was 71.8% of all 30 patients: 75% in 10 early stages and 70% in 20 advanced ones. In mandible surgery, 83% of 13 marginal resections and 75% of 12 segmental and hemiresections were superior than in 30% of 5 patients without surgery. In 9 patients that died, 5 distant metastasis (55.6%) showed a higher survival rate than 3 primary tumors (33.1%) and 1 regional lymph node metastasis (11.1%).

Seven split and 3 full thickness skin grafts for malignant tumors after radiotherapy were performed for the following purposes: Biological dressing and promotion of healing for resection wounds and retention of the reduction after marsupialization wounds of the maxillary sinus. The skin grafts were used for reconstruction of defects following surgery of the smaller superficial tumors. All grafts were taken from femoral skin. Recipient sites were as follows; 1 maxilla, 5 maxillae and buccal mucosae, 3 mandibles and 1 tongue. In 10 patients preoperative chemotherapy was carried out and also in 8 of them irradiation of 10-88 Gy.All grafts were alive and a necrotic bone piece each was found in the wounds of a maxilla and a mandible 1 or 2 months later. The skin grafts were very useful for insertion of denture except 1 patient with teeth and satisfactory results were obtained.