• Title/Summary/Keyword: 국소 마취

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Botulinum Toxin type A injection Versus Lidocaine Injection for Myofascial Pain Involving upper Trapezius (승모근 근막동통에 대한 보툴리눔 독소와 리도카인 주사의 치료효과 비교)

  • Ahn, Sung-Woo;Park, Eun-Hee;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.345-351
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    • 2005
  • The purpose of this double-blind study was to evaluate clinical effects of botulinum toxin type A (BTX-A) injection on myofascial pain syndrome (MPS) involving upper trapezius and compare with those of lidocaine injection. 21 patients presenting with active TrP1 and/or TrP2 in the upper trapezius over 6 months were selected for this study. The subjects were randomly divided into two groups; one group injected with BTX-A (15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP)) and the other group injected with 0.5% lidocaine (0.3 ml /TrP). The clinical effects were evaluated by VAS and PPT at baseline, 2, 4, 6 and 8 weeks after treatment. BTX-A group showed persistent decrease of VAS values and increase of PPT values following treatment. While there was no significant difference in VAS values between BTX-A and lidocaine groups (p=0.347), there was significant difference in PPT values after treatment between two groups (p=0.000). The subjects received BTX-A showed noticeable improvement in PPT values after treatment, suggesting more reliable effect of BTX-A injection compared with lidocaine injection. The results of this study support that the direct injection of BTX-A to a TrP is an effective and safe treatment for MPS involving upper trapezius.

The Effects of the Hand-holding Program as an Independent Nursing Intervention for the Patients with Anxiety in Local Anesthesia (국소마취 백내장 수술환자의 불안에 대한 직접간호중재로서의 손잡아주기 프로그램 효과)

  • Kim, Kwuy-Bun;Kim, Kwang-Joo;Lee, Hyang-Yeon;Shin, Hye-Sook;Chae, Jeong-Sook
    • Journal of East-West Nursing Research
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    • v.4 no.1
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    • pp.7-20
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    • 1999
  • Operation usually brings about psychological stress as well as physical stress to the patient and it greatly influences the maintenance of the homeostasis. Until now, most of the nursing research concerning the anxiety of the patient undergoing an operation has been done while the patient was under general anesthesia. Under local anesthesia, the anxiety of the patient who undergone operation is short. However, there is much demand of the operational nurses to mediate between the patient who is undergoing operation when fully conscious, as they are aware of the patient's anxiety and to decrease the patient's anxiety of this local anesthesia. Therefore, this research tries to verify the effects of the Hand-holding program on the anxiety of the operational patient undergoing local anesthesia and affirms the role of the nursing intervention. As an unequivalent control group non-synchronized designs, this research selects out 20 control groups and 21 experimental groups at random who have received cataract operation while under local anesthesia and after implementing the Hand-holding program to the experimental groups while undergoing the operation, the effect of the experiment was observed. By observing the Epinephrine, Cortisol, blood pressure, and pulse for the physical indexes before and after the enforcement of the hand-holding, and using the measurement of Speilberger(1972) for the psychological indicators for the anxiety of the patient before and after hand-holding, the results were analyzed through SAS program. As a results, intervention of hand-holding had a remarkable effect to decrease the anxiety felt by the patient and the diastolic blood pressure also was effectively decreased. On the other hand, through the decrease of the systolic blood pressure was also observed, it was not statistically significant. In the Epinephrine and Cortisol indicators, the intervention of hand-holding was revealed to have an insignificant effect. The Hand-holding was revealed to have an indicators, the intervention of Hand-holding was revealed to have an insignificant effect. The Hand-holding program may be said to have an effect which decreases the psychological anxiety of the patient undergoing local anesthesia.

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Remote Afterloading High Dose Rate Brachytherapy AMC EXPERIANCES (원격조정 고선량 근접 치료)

  • Park, Su-Gyeong;Chang, Hye-Sook;Choi, Eun-Kyong;Yi, Byong-Yong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.267-275
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    • 1992
  • Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

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A Study on the Confidence of Dry Eye Diagnosis Methods (건성안 검사 방법의 신뢰도에 대한 연구)

  • Lee, Byeong Jun;Hong, Jae Hyeon;Jung, Dai;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.1
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    • pp.15-20
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    • 2008
  • Purpose: To study on the confidence of dry eye diagnosis methods which need to prescribe contact lens. Methods: Non-invasive tear film break-up time (NIBUT) and tear film break-up time (TBUT) were measured in forty healthy subjects in their 20s, and then the subjects were classified into normal eye and dry eye. The results of McMonnies questionnaire, tear prism height measurement, Hardtack test, blink rate measurement and Schirmer test were compared with the results of NIBUT and TBUT. Results: The results of NIBUT and TBUT were as follows; 20 subjects had normal eyes, 10 subjects had dry eyes in both NIBUT and TBUT, and 10 subjects showed different results. In McMonnies questionnaire, the score of normal eye group averaged 8.2 and that of dry eye group averaged 18.5, which showed statistically significant difference. Furthermore, 100% of normal eye group classified by the results of NIBUT and TBUT corresponded with the result of McMonnies questionnaire and 90% of dry eye group showed the correspondence. Tear prism height of normal eye group averaged 0.32 mm and that of dry eye group averaged 0.23 mm, which were significantly different. Hardtack test, blink rate measurement and Schirmer test without local anesthesia showed no statistically significant difference between normal eye group and dry eye group. Conclusions: On dry eye diagnosis methods, the results of McMonnies questionnaire and tear prism height measurement had close correlation with the results of NIBUT and TBUT.

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Ultrasonography-Guided Multiple Needling for Calcific Tendinitis of the Shoulder (견관절 석회화 건염의 초음파 감시하 다발성 천공술)

  • Jeong, Woong-Kyo;Park, Jung-Ho;Moon, Joon-Gyu;Kim, Ho-Joong;Lee, Soon-Hyuck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.74-78
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    • 2009
  • Purpose: To evaluate the effectiveness of ultrasonography-guided multiple needling for calcific tendinitis of the shoulder. Materials and Methods: We included 18 symptomatic calcific tendinitis patients who underwent ultrasonography-guided multiple needling and followed for average 17 weeks. The procedures were multiple needling or aspiration of the calcific deposit and injection of local anesthetics and steroid into the subacromial bursa under the ultrasound control. Clinical improvements were evaluated using pain VAS, UCLA score and KSS score. The size and status of calcific deposits were compared. Results: A significant improvement was seen in pain VAS, UCLA score and KSS score (p<0.05). At the final follow up, the calcific deposits had resolved completely of nearly completely in 39%, and the size was decreased in 61%. Conclusion: Ultrasound-guided multiple needling is considered as a useful method which could provide prompt pain relief and reduce calcific deposit for calcific tendinitis of the shoulder.

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Randomized Controlled Trial of East-West Collaborate Medical Treatment on Female Chronic Shoulder Pain Patients (여성 만성견비통 환자에 대한 동서 협진 치료의 무작위 대조군 연구)

  • Nam, Dong-Woo;Choi, Yang-Sik;Kim, Haeng-Beom;Kim, Jong-In;Lim, Sabina;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.113-122
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    • 2007
  • 목적 : 만성 견비통 환자에 대한 침 치료와 신경 차단술 병행 치료의 효과를 검증하고자 함. 방법 : 만성 견비통 환자 60명을 대상으로 동서병행치료군(EW group, n=20), 한방 침치료군(E group, n=20), 무처치 대조군(C group, n=20)으로 무작위 배정한 후 연구를 시작했다. 동서병행치료군은 먼저 견갑상 신경차단술, 견봉하 주사 및 압통점 국소 마취제를 맞은 후 5분간 휴식을 취한 후 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 주 2회 4주간 받았다. 한방 침치료군은 주 2회, 4주간 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 받았으며, 무처치 대조군은 4주간 특별한 처치를 받지 않았다. 모든 환자들은 일상생활에서 자가 운동을 실시하도록 지시 받았다. 치료 시작전과 치료 4주 후 Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), 및 환자의 주관적 통증 평가를 Visual Analogue Scale(VAS) 로 측정하여 모인 데이터 통계를 분석하였다. 결과 : 동서병행치료군 및 한방 침치료군 모두 CSA, SPADI 및 VAS 상에서 유의한 (p<0.05) 호전을 보였다, 동서병행치료군의 CSA, SPADI, VAS는 무처치 대조군과 비교하여 유의한 우의를 나타냈으며, 한방 침 치료군과 비교하여 VAS 에서 유의한 차이를 나타냈다. 결론 : 침치료와 신경차단술 병행 치료방법은 만성 견비통을 유의하게 호전시켰다. 무처치 대조군과의 차이는 3개의 측정 도구 모두에서 유의한 차이가 있었으며, 침치료만 받은 환자들과도 주관적 통증 척도에서 유의한 차이를 보였다.

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Management of Traumatized Gingival Wound Using Tissue Adhesivein Dental Hygiene Practice (치위생 임상에서 조직접착제를 활용한 외상성 치은열창의 처치)

  • Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok
    • Journal of dental hygiene science
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    • v.3 no.1
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    • pp.1-4
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    • 2003
  • The purpose of this paper is to present the potential application of tissue adhesive in the management of traumatized gingival wound in clinical dental hygiene practice. Cyanoacrylate adhesive has been used for closure of superficial laceration without suturing, which is available in periodontal and oral surgery. Small gingival or mucosal lacerations may occur by improper or excessive instrumentation of the dental hygienist during scaling and root planing procedure. In this circumstances, tissue adhesive is very effective, simple, and convenient method as an alternative to conventional wound closure by suturing. The tissue adhesive consists of monomeric n-butyl-2-cyanoacrylate, which polymerizes quickly in contact with tissue fluid. The sutureless treatment of gingival laceration with tissue adhesive has advantages of good esthetic results, less trauma, time saving, antibacterial and hemostatic effects. In addition, local anesthesia as well as re-visit for dressing and removal of suture are not required. Use of tissue adhesive could be beneficial to both dental hygienist and patient in the management of procedural error.

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Effect of vapocoolant spray and EMLA cream upon DPT vaccination pain in infants (DPT 예방접종 시 냉각 스프레이와 EMLA의 통증경감 효과)

  • Jang, Gunja;Jeon, Eunyoung;Lee, Eunsil
    • Journal of the Korean Data and Information Science Society
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    • v.25 no.4
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    • pp.705-714
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    • 2014
  • This study aimed at identifying the effect of vapocoolant spray and EMLA (eutectic mixture of local anesthetics) cream upon DPT (diphtheria-pertussis-tetanus)vaccineassociated injection pain in infants. A nonequivalent control group pretest-posttest design was used. The subjects were 49 infants, 19 of them for control group, 15 of them for vapocoolant group, and 15 infants for EMLA group. Pulse and oxygen saturation as pain indicators were measured before and after DPT vaccination. FLACC was also measured after vaccination. The data were collected between October 2009 and June 2010 and analyzed using SPSS WIN 20.0. EMLA group had significant a little changes in pulse (F=43.37, p <.001) and oxygen saturation (F=9.86, p=.003) compared to the control and vapocoolant group. But there was no difference in FLACC pain score among three groups. This results showed that EMLA cream is an effective agent for reducing DPT vaccination-associated pain. Therefore, EMLA cream can be used to reduce pain at public health centers and clinical settings.

Calcifying Aponeurotic Fibroma - A Case Report - (석회화 건막 섬유종 - 증례 보고 -)

  • Paik, Seung-Sam;Jang, Ki-Seok;Han, Hong Xiu;Kim, Hyung-Jong;Roh, Won-Il;Lee, Seong-Pil;Lee, Kwang-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.233-237
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    • 2003
  • Calcifying aponeurotic fibroma is a benign, aggressive fibrous tumor seen in childhood or adolescence that most commonly affects the palm. We report our experience in treating calcifying aponeurotic fibroma in the hand of fifteen-year-old boy. He was presented with a recurrent mass in hypothenar area of his left hand. He had a history of local excision of the mass 7 years ago in local clinic. The palpable mass was hard, tender and movable. The simple X-ray revealed multifocally scattered microcalcifications in the mass. The excised mass showed the features of dense fibrotic soft tissue tumor with multiple small whitish calcifications. The microscopic sections showed a lobulated and a poorly circumscribed proliferation of dense fibrous tissue, containing islands of metaplastic chondroid differentiation with prominent calcification. The recommended treatment of this lesion is wide excision allowing for sparing of functional or vital structures, but high recurrence rate as this case has been reported to be more than 50 percent.

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DENTAL TREATMENT OF THE PATIENT WITH AUTISM AND HEMOPHILIA A UNDER GENERAL ANESTHESIA A CASE REPORT (자폐증상이 있는 혈우병 A 환아의 전신 마취를 통한 치과적 치험례)

  • Park, Kyeong-Sun;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.593-600
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    • 1996
  • This case report is a treatment of patient with hemophilia A and autism. The patient's chief complaint was treatment of dental caries on entire dentition and he has an impacted mesiodens located on the apex of the upper right primary central incisor. The patient was consulted with pediatrician and anesthetist about the detailed discussion of the complexities of hemorrhagic disorder. Because he had some problems of behavior management and bleeding, the treatment was done under the gerneral anesthesia. The following results were obtained. 1. Consult with the patient's physician and hematologist about the replacement therapy and bleeding tendency. 2. For the severe hemophiliac child who requires extensive or surgical treatment, general anesthesia may be indicated for the comprehensive care. 3. For the hemophiliac child who has a behavior management problem due to autism and other defects, general anesthesia may be considerable. 4. Care must be taken during dental procedures not to causing a bleeding. 5. Local hemostatic methods must be acquired for the emergency state. 6. Neve prescribe aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and phenylbutazone. These drugs affect platelet aggregation and exaggerate the bleeding defect. 7. Do not be afraid of hemophiliac patient, and never compromise quality of dental care.

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