| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2012: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2011: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2010: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Research Abstract |
In the dental treatment of the elderly, there is a considerable risk of medical complications. The most frequent medical emergency is hypertensive crisis. Hypertensive crisis is not only high blood pressure, but also has potential risk of severe arrhythmia, myocardial ischemia or cerebrovascular accident. In the clinical setting, its prevention is given higher priority from the view point of risk management. Circulatory system is controlled by highly complex regulation with many layers of positive and negative feedback. The main purpose of this system is to keep equilibrium state from all kind of disturbances. However, the function of this stabilization system will decrease with ageing. Hypertensive crises frequently seen in dental treatment of the elderly, and is notable expression of this functional disability. For the prediction of hypertensive crises, dynamic assessment of stabilization system is essential. However, it was very difficult to understand its input-output characteristi
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cs because of its high complexity with non-linearity. I think that the system identification method can be useful for mathematical assessment of this black box system.The purpose of this study is to develop prediction method of hypertensive crisis in dental treatment of elderly. However, autonomic function during dental care of the elderly with or without hypertensive crisis should be evaluated before the assessment of the black box system. There is no systemic study for this relation in the elderly dental outpatients as far as we know. Autonomic tone was analyzed using FFT and AR model of heart rate variability in the two group patients. As a result of this study, patients with hypertensive crisis showed significant increase insympathetic tone and decrease in parasympathetic. This result is reasonable and easy to understand. On the subsequent study, the parameters in systemic identification analysis, impulse response, transfer function, baroreceptor reflex and background factors of the patients were analyzed. However, stable and rational results cannot be obtained. Less
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