In Februry 1993. a 18-years old woman was referred to the Department of Oral Surgery and Dentistry, Kohga public hospital The radiograph showed a large follicular cyst in the left maxillary sinus.
Upon the admission to our hospital the patient was in good general health except for the extra oral swelling of the left side of the face.
In March 1993, the surgical management of the lesion was done by local anesthesia (1% xylocaine+epinephrine). Near by the final suture, the tachycardia (heart rate 160/min), depressed ST on ECG, hypertension (220mmHg), and the murmur of heart turn up. The patient recovered from symptomes by the administration of β-blocker and vasodilator and an oxygen inhalation. ASD was detected by Echogram. On the next day, the murmur of the heart and the tachycadia was disappeared.

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Twenty diabetic patients with complications, who were seen in our clinic (October, 1991-April, 1994), were observed clinically. Of the oral diseases excluding tooth caris, radicular cyst (7 cases) as result of the carious involvement had a high incidence, followed by oral carcinima (3 caces), periodontitis (3 caces), epulis (2 caces), sialolithiasis (2 cases), etc. Of the diabetic complications, cardiovascular diseases (8 caces), viral hepatitis C and/or liver diseases (9 caces), ophthalmopathy (9 caces) including two blind patients, renal failure (2 cases) including a patient undergoing dialysis, were seen. The coincidence of diseases increased with age.
We concluded the following: 1. Linking of medical departments with diabetic clinic is necessary for cure and/or care of the diabetic patients. 2. It is important to improve the quality of oral hygine and dental practices for “dental medicine for medically compromised patients.” 3. A methodology for clinical statistics to analyze complex diseases of diabetes is required.

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Statistical study was made in relation to the dental visiting care in the nursing homes for the aged in Yamagata pref.
1) The total number of patients were 98, 26 males and 72 females.
2) The ratio of the medically compromised patients amounted to 98%. In the classification by types of diseases, the patients with cerebra-vascular diseases wereoverwhelmingly many. There were 72 patients (73.5%) with two or more diseases.
3) 91% of patients took several drugs. Improving agent for cerebral circulation and metabolism was the most popular drug.
4) Concerning ADL such as eating, 12 patients could not take care of themselves, the majority of them had cerebrovascular diseases.
5) The most popular treatment was trimming of teeth stump. The incidence of endodontic treatment was minimal.
6) The ratio of dental caries was 58.1%, among of them 66.2% were teeth stump.

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Paroxysmal supraventricular tachycardia (PSVT) can be defined as a regular tachycardia (heart rate up to 250 beats/min) that begins suddenly. In this paper, the authors report electrocardiographic findings and management of PSVT occurred after local anesthesia for intraoral surgical procedure.
Electrocardiographic characteristics of PSVT in this case revealed atrioventricular nodal reentry. Vagal stimulation techniques and intravenous administration of diazepam, propranolol and adenosine-5'-triphosphate (ATP) were tried to terminate the tachycardia. ATP terminated the tachycardia within less than 1 minutes. We conclude that ATP is the safest and most effective drug of first choice in the acute management of PSVT.

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Myotonic dystrophia (MD) is a systemic lesion in muscles, internal sections and central nerve system and one of rare autosomal dominant diseases. Accordingly, certain factors must be considered when surgical procedures under general anesthesia are indicated for the patients.
We experienced to excise a parotid tumor in a 48 year old man with MD.The slow induction was managed with midazoram and GOS, and the intubation could be performed easily without any musculer relaxant. The anesthetization was maintained with GOT. In theoperation, no physiological problem arose. Oxigen inhalation and its saturation monitor in blood was remained until next morning, however the patient recovered well through. The wound healingwas fair, and currently the patient has no complication as such as tumor recurrence neitherfacial nerve disorder.
Since there are various symptoms in MD, general condition of the patient must be estimated carefully prior to surgery.

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