Publications by authors named "Ryo Wakita"

Radiation therapy (RT) for head and neck cancer, which has made remarkable progress in recent years, is one of the main treatment modalities because it can preserve organ function and morphology after treatment. However, while RT is widely used, complications have been reported, especially laryngeal edema, which can be an airway management problem during general anesthesia. Of the 3 cases of RT-induced laryngeal edema presented here, the first developed 4 days post-RT, the second manifested signs and symptoms associated with laryngeal edema after RT performed 4 years and 4 months previously, and the third exhibited severe laryngeal edema over a decade post-RT despite the absence of clinical signs and symptoms.

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Objective: The Drug Lymphocyte Stimulation Test (DLST), recognized for its safety as an allergy diagnostic modality, has been acknowledged for its utility in diagnosing drug-induced pathological conditions. However, reports elucidating DLST outcomes concerning local anesthetics are notably scarce.

Materials And Methods: An exhaustive analysis was conducted on the DLST results pertaining to local anesthetics derived from 571 patients presenting with suspected allergies to these specific agents.

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Background: Local anaesthesia in dental procedures is generally safe, although the occurrence of transient bradycardia (TB) has occasionally been reported. TB is often associated with two reflexes, the trigeminal cardiac reflex (TCR) and the vasovagal reflex (VVR) and is characterised by a rapid decrease in heart rate (HR) and blood pressure (BP). The prevalence of TCR is considered low, and its predictors have not been thoroughly investigated, although an association with the gag reflex has been suggested in recent years.

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Aims: Potocki-Lupski syndrome (PTLS), which is caused by the partial duplication of the short arm of autosome 17, is characterized by feeding difficulties associated with muscle hypotonia and dysphagia in infancy, followed by growth retardation and low body weight in later stages. Speech and motor developmental disorders are observed in childhood, accompanied by autism spectrum disorders in several cases. Other disorders include dental and skeletal abnormalities, and associated sleep apnea.

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Background/purpose: The possibility of triggering the trigeminocardiac reflex (TCR) during oral surgery is considerably lower than that during other surgeries. A reduced heart rate (HR) of ≥20% from baseline is usually considered a diagnostical criterion for the TCR. Our automated anesthesia charting system often revealed cases of slight transient HR decrease during sedation.

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Purpose: Vitreoretinal lymphoma is a high-grade malignant non-Hodgkin lymphoma with poor prognosis. The objective of this study was to elucidate the proteome profile of the vitreous in patients with vitreoretinal lymphoma (VRL), aiming to advance understanding of the pathophysiology of VRL.

Methods: Comprehensive proteomic analyses of vitreous humor using liquid chromatography with tandem mass spectrometry were performed for 10 patients with VRL, 10 control patients with idiopathic epiretinal membrane or macular hole, and 10 patients with ocular sarcoidosis.

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Sudden cardiac arrest (SCA) is an uncommon event in dental practice; however, the frequency of dentists encountering SCA and other major medical emergencies is increasing. We report the successful resuscitation of a patient who developed SCA while awaiting examination and treatment at a dental hospital. The emergency response team was called upon, and cardiopulmonary resuscitation/basic life support (CPR/BLS), including chest compression and mask ventilation, was promptly initiated.

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Implant surgery is a lengthy dental procedure, and sedation is often used to reduce discomfort. The effectiveness of sedation has traditionally been evaluated in terms of patient and surgeon satisfaction, but the most important goal is not to induce a deep sleep in the patient, but rather to ensure that the surgery is performed safely and as planned. Additionally, adequate pain control is a necessary requirement for patient and surgeon satisfaction.

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Prior to a scheduled operation for a 45-year-old male patient with tongue cancer, a tracheotomy performed under intravenous sedation to prevent asphyxia due to extensive bleeding resulted in pneumomediastinum and subcutaneous emphysema. The planned operations were postponed until reduction of the pneumomediastinum was confirmed. During operation, airway pressure was kept low to prevent tension pneumomediastinum along with a sufficient depth of anesthesia, controlled analgesia, and continuous administration of muscle relaxants.

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Pulse wave transit time (PWTT) is the time difference between the occurrence of an R-wave on an electrocardiogram and the detection of pulsatile signals on a pulse oximeter, which reflects changes in blood pressure (BP) corresponding to the vessel wall compliance. However, the factors affecting PWTT variability have not been determined. Thus, we investigated the BP changes associated with variations in PWTT and identified the clinical characteristics associated with these variations.

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Ocular sarcoidosis is an inflammatory disease that manifests as uveitis, and is often difficult to distinguish from other forms of uveitis based on nonspecific findings alone. Comprehensive proteomic analyses of vitreous humor using LC-MS/MS were performed in each patient with ocular sarcoidosis, vitreoretinal lymphoma (VRL), and controls with epiretinal membrane or macular hole. Differential expression proteins (DEPs) were identified by comparing with VRL and controls, and functional pathway analysis was performed.

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Purpose: To identify tissue metabolomic profiles in biopsy specimens with IgG4-related ophthalmic disease (IgG4-ROD) and mucosa-associated lymphoid tissue (MALT) lymphoma and investigate their potential implication in the disease pathogenesis and biomarkers.

Methods: We conducted a comprehensive analysis of the metabolomes and lipidomes of biopsy-proven IgG4-ROD (n = 22) and orbital MALT lymphoma (n = 21) specimens and matched adjacent microscopically normal adipose tissues using liquid chromatography time-of-flight mass spectrometry. The altered metabolomic profiles were visualized by heat map and principal component analysis.

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Purpose: Low power mode (LPM) can be used for subthreshold retinal laser treatment by simply adjusting the laser parameters. Herein, we report the use of a modified LPM laser treatment for four cases of central serous chorioretinopathy (CSCR).

Patients And Methods: We retrospectively reviewed the medical records of four patients (four eyes) with persistent CSCR who underwent modified LPM laser for leakage.

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The activities of various metabolic pathways can influence the pathogeneses of autoimmune diseases, and intrinsic metabolites can potentially be used to diagnose diseases. However, the metabolomic analysis of patients with uveitis has not yet been conducted. Here, we profiled the serum metabolomes of patients with three major forms of uveitis (Behҫet's disease (BD), sarcoidosis, and Vogt-Koyanagi-Harada disease (VKH)) to identify potential biomarkers.

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Lidocaine has been used as a local anesthetic by injection. The controlled release of lidocaine loaded into nanospheres is necessary to reduce the onset time of the anesthetic effect or increase the anesthetic analgesia duration. In this study, mesoporous silica nanoparticles (MSNs) with a large specific surface area were prepared by a sol-gel method, and the interfacial interaction between MSNs and lidocaine positively charged in aqueous solutions at different concentrations was investigated by adsorption tests, Fourier-transformed infrared spectroscopy, thermogravimetry-differential thermal analysis, and Brunauer-Emmett-Teller (BET) measurements.

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Bisphosphonates (BPs) containing nitrogen (N-BPs) exhibit far stronger anti-bone-resorptive effects than non-N-BPs. However, repeated administration of N-BPs causes osteonecrosis selectively in jawbones. As BPs accumulate in large amounts within inflamed bones, any N-BP released from the pool accumulated within jawbones might directly act on cells in the surrounding soft-tissues and induce inflammation or necrosis.

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During intravenous sedation, a decrease in SpO2 is usually the result of respiratory failure. However, we experienced a case with SpO2 decrease that was caused by methemoglobinemia in prilocaine infiltration anesthesia during sedation. This indicates that methemoglobinemia should be considered if low SpO2 is sustained unrelated to sedation level.

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Norepinephrine modulates synaptic plasticity in various brain regions and is implicated in memory formation, consolidation and retrieval. The cerebellum is involved in motor learning, and adaptations of the vestibulo-ocular reflex (VOR) and optokinetic response (OKR) have been studied as models of cerebellum-dependent motor learning. Previous studies showed the involvement of adrenergic systems in the regulation of VOR, OKR and cerebellar synaptic functions.

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Article Synopsis
  • The study explored how well lidocaine ions move through a cellophane membrane using direct current (DC) and alternating current (AC) methods for efficient drug delivery.
  • The experiments involved monitoring lidocaine concentrations in a receptor cell over 60 minutes using different voltage combinations, revealing that certain DC/AC combinations led to significantly higher lidocaine concentrations compared to passive diffusion.
  • Results indicated that DC was more effective for faster lidocaine transport, especially when switching from DC to AC, highlighting the potential of combining both currents for improved drug delivery efficiency.
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Iontophoresis (IOP) is a noninvasive method of delivering medication transcutaneously through the skin. The electrodes used in this method should tightly fit to rough and irregular surfaces and be biologically safe, easy to handle and prepare, and cost-effective. To satisfy these requirements, calcium alginate gel can be a candidate electrode for IOP.

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The aim of this study was to determine transport of lidocaine ions through a hairless rat skin in vivo and to compare the efficacy of alternating current (AC) with that of direct current (DC) iontophoresis (IOP). We measured the concentration of lidocaine transported through a cellophane membrane or a hairless rat dorsal skin applying either AC-IOP or DC-IOP. The results revealed that lidocaine concentration increased in a time-dependent manner in vitro in both DC-IOP and AC-IOP.

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β-Agonists are the first-line therapy to alleviate asthma symptoms by acutely relaxing the airway. Purified components of ginger relax airway smooth muscle (ASM), but the mechanisms are unclear. By elucidating these mechanisms, we can explore the use of phytotherapeutics in combination with traditional asthma therapies.

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Article Synopsis
  • Dexmedetomidine (DEX) is valuable for dentistry due to its low respiratory depression but can cause patients to suddenly appear alert during procedures, while midazolam (MDZ) provides strong amnesia.* -
  • A study with 43 participants tested different dosing strategies of MDZ and DEX to assess sedation quality, amnesia, and patient satisfaction.'* -
  • The best sedation was achieved with a combination of MDZ (0.02 mg/kg plus 0.01 mg/kg every 45 minutes) and DEX (2 µg/kg/h initially, then 0.5 µg/kg/h), while group 4 (only DEX) showed no amnesia early on and group
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Calcium alginate gel has some unique properties, such as the capability to keep the drugs, bioadhesiveness, safety, and low cost. The purpose of this study is to determine whether calcium alginate gel can be used as a matrix of electrodes for iontophoresis (IOP). We measured the concentration of lidocaine transported from calcium alginate gels with various concentrations of alginic acid using an in vitro experimental cell with square-wave alternating current (AC) application.

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We assessed the effect of the duty cycle on the anesthetic effect during lidocaine alternating current (AC) iontophoresis. A solution of 2% lidocaine was delivered to the medial antecubital skin for 20 minutes using AC iontophoresis with a duty cycle of 60%, 70%, or 80%. The von Frey test was then performed to evaluate the anesthetic effect.

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