• Title/Summary/Keyword: 국소 마취

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A STUDY ON THE INFLUENCE OF EPINEPHRINE CONTAINED IN DENTAL LOCAL ANESTHETIC AGENTS ON THE BLOOD SUGAR OF DIABETES DURING MINOR ORAL SURGERY (치과용 국소마취제에 포함된 Epinephrine이 당뇨 환자의 소수술시 혈당에 미치는 영향에 관한 연구)

  • Yun, Hyung-Jin;Rim, Jae-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.5
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    • pp.463-471
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    • 2005
  • Recently, the number of diabetic patients have been increased with westernized living way and meal habitation. The regulation of blood sugar concentration is very important for diabetic patients to keep homeostasis and, to prevent acute or chronic complications. Epinephrine combined with lidocaine is used in dental clinic extensively. And epinephrine combined with lidocaine also effects on decreasing the blood leakage volume by constricting micro vessle and arteriole. But, So far there are few researches about the effect of epinephrine contained in dental local anesthetic agent on the blood sugar of diabetes during minor oral surgery. The purpose of this study was intended to investigate whether epinephrine which combined with dental local anesthetics influence body glucose level in diabetes patients by glucose monitoring. The subject of this study were 38 diabetic patients and 38 normal adults, each patient was checked body glucose after a meal 2 hours later with resting state, and injection 1:100000 epinephrine with dental lidocaine 54 ml or lidocaine 54 ml only. And then the body glucose level was checked 5 minutes and 30 minutes after injection. The results were analyzed by two way ANOVA test (p<0.05). The results were as follows: In the experimental group 1, the mean of the blood sugar level was 180.3 mg/dl before an anesthetic injection, 182.8 mg/dl after 5minutes of the anesthetic injection and 182.2 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the experimental group 2, the mean of the blood sugar level was 237 mg/dl before an anesthetic injection, 234.5 mg/dl after 5minutes of the anesthetic injection and 231.8 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 1, the mean of the blood sugar level was 117.6 mg/dl before an anesthetic injection, 119.1 mg/dl after 5minutes of the anesthetic injection and 129.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 2, the mean of the blood sugar level was 104.2 mg/dl before an anesthetic injection, 102 mg/dl after 5minutes of the anesthetic injection and 105.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05).

Development of Detachable IORT Table for Colorectal Cancer (장착-탈거 및 경사각 조절이 가능한 대장직장암의 수술 중 방사선 치료대의 개발)

  • Kim, Myung-Se;Lee, Joon-Ha
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.117-121
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    • 1994
  • In spite of remarkable improvement of surgical skills and anesthesia, local failure still occurred in 36-45$ \% $ of locally advanced colorectal cancer after curative resection with or without pre-or post-operative irradiation. Intraoperative radiation therapy(IORT) is the ideal modality which resectable lesions are removed surgically 3nd the remaining cancer nests are sterilized by irradiation during a surgical procedure. Therefore, the excellent local control without the damage of the adjacent normal tissues can be achieved. In IORT, judicious set up of the treatment cone on the treatment surface of the patient is required for accurate and homogenous dose distribution within treatment field, especially on the slopping surface of sacrum and pelvic sidewall which are the common sites of the local recurrence in rectal cancer. For this purpose, adequate co-ordination of gantry rotation and table tilting are essential. Adjusting gantry rotation is not difficult but tilting of the table is impossible inconventional treatment couch. Department of Therapeutic Radiology in Yeungnam University Medical Center developed the IORT table for colorectal cancer which is easy to set up and detach on the Linac treatment couch within 5 minutes. The range of tilting with head-up and head-down is about 30 degree which is efficient and easy-to-use, not only for IORT but also for colorectal surgery. So far, authors performed IORT with newly developed treatment table in 2 patients with rectal cancer and we found that this newly developed table could contribute in improving the dose distribution of IORT and surgical procedure for colorectal cancer.

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In Vivo Study on the Biocompatibility of New Resin-based Root Canal Sealers (신개발 레진 계열 봉함제의 생체친화성에 관한 연구)

  • Kim, Yong-Beom;Baek, Seung-Ho;Bae, Kwang-Shik
    • Restorative Dentistry and Endodontics
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    • v.27 no.2
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    • pp.122-134
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    • 2002
  • 목적 : 근관 치료의 최종 목적인 근관계의 영구적인 충전을 위해 사용되는 근관 봉함제는 많은 연구와 개선을 거쳐서 현재는 다양한 성분의 봉함제가 시판되고 있다. 이중에서 레진이 주성분인 봉함제는 조작이 편리하고 흐름성이 좋으며 근관의 벽에 높은 밀폐성을 보이고 충분한 작업시간과 높은 방사선 불투과성을 가지는 장점을 가짐에도 불구하고 높은 초기 생체 독성을 나타내는 단점을 가지고 있다. 본 실험에서는 기존의 상용화된 제품 중 레진이 주성분인 두 종류의 봉함제(AH 26, AH plus)와 산화아연이 주성분인 봉함제(Pulp Canal Sealer EWT)와 국내에서 새로이 개발한 제품으로서 레진이 주성분인 두 종류의 봉함제(Adseal-1,2)를 생체조직에 매식하여 국소적인 반응을 비교하여 생체친화성을 알아보고자 하였다. 방법 : 수종 봉함제의 생체 친화성을 알아보기 위하여 64마리의 Sprague-Dawley rat을 사용하였다. 봉함제의 피하조직 매식을 위해 길이와 직경이 각각 5와 1.5mm인 폴리에틸렌 테프론 관을 사용하였으며 이를 에탄올과 증류수로 세척 한 후 고압증기멸균을 시행하였다. Rat에 대하여 케타민으로 복강내 마취를 시행한 후 배부를 면도하고 iodine으로 소독한 다음 네 곳에 절개를 시행하였으며 blunt dissection을 통해 깊이 10mm이상의 피하조직 pocket을 형성하였다. 각각의 봉함제를 제조사의 지시 에 따라 혼합 후 즉시 멸균된 테프론 관에 주사기를 이용하여 담은 다음에 봉함제가 흐르지 않게 유의하며 pocket내로 삽입하였으며 이때 16개의 관을 대조군으로 사용하기 위해 봉함제를 넣지 않은 상태로 삽입하였다. 이 후 절개 부위를 surgical gut suture로 봉합하였으며 1주일 후에 발사하였다. Rat을 1, 2, 4, 12주 후에 각 군 당 세 마리 씩 에테르 흡입을 통해 희생하였으며 이 때 한 마리씩의 대조군도 포함시켰다. 이 후 매식된 관을 주위 조직과 함께 제거하고 포르말린에서 48시간 고정시킨 후 파라핀에 포매한 다음에 micro-tome을 사용하여 6$\mu\textrm{m}$로 serial section을 시행하였다. 정중선 부위의 시편에 Hematoxylin-Eosin staining을 시행한 후 Olsson, Orstavik 그리고 Mjor 등의 방법에 따라 조직학적 변화를 관찰한 후 slight(1), moderate(2), severe inflammation(3)의 단계로 분류하였다. 얻어진 결과를 통계처리 프로그램인 Jandel사의 Sigmastat을 이용하여 Kruskal Wallis Test로 통계처리를 하였다. 결과 : (Table omitted) 결론 : 1) Pulp Canal Sealer를 제외한 모든 군에서 시간이 지남에 따라 유의성 있게 염증이 감소되는 양상을 보였다(p<0.05). 2) Pulp Canal Sealer는 1주, 2주, 12주에서 강한 염증반응을 보였다. 3) AH 26과 AH Plus에서는 1주, 2주에서 강한 염증반응을 보였으나 12주에서는 염증반응이 감소하였다. 4) 새로 개발된 봉함제 Adseal-1,2는 1주, 2주에서는 가장 약한 염증반응을 보이나 4주, 12주 후에는 AH Plus와 비슷한 수준의 염증 반응을 보였다. 5) Pulp Canal Sealer를 제외한 모든 군에서 인정할 만한 생체친화성을 보였다. 6) Adseal-2가 Adseal-1에 비하여 전반적으로 낮은 염증반응을 보였다. 7) 각 군간 결과의 차이에 통계적 유의성은 없었다(p>0.05).

Continuous intra-lesional Infusion Combined with Interscalene Block for Effective Postoperative Analgesia after Arthroscopic Shoulder Surgery (상완신경총 사각근간 차단과 국소마취제의 병소내 지속주입법의 병용이 견관절경 수술 후 진통에 미치는 영향)

  • Oh Joo-Han;Kim Jae-Yoon;Gong Hyun-Sik;Kim Jae-Kwang;Kim Sang-Gee;Kim Tae-Yune;Rhee Ka-Young;Kim Woo-Sung
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.141-147
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    • 2005
  • Purpose: The purpose of this study was to compare the effectiveness of postoperative pain control by intravenous patient-controlled analgesia (IV) to the effectiveness of postoperative pain control by continuous intra-lesional infusion of local anesthetics (IL) with or without an interscalene brachial plexus block (ISB) after arthroscopic shoulder surgery. Materials and Methods: We designed this prospective randomized case-controlled double-blind study, and allocated 84 consecutive patients to four groups according to postoperative analgesic method, i.e., Group IV, Group ISBIV, Group IL, and Group ISB-IL after arthroscopic shoulder surgery. Postoperative pain, side effects and supplemental analgesics were recorded at 1 hour and then at every 8 hours for 2 days. Result: The demographic and clinical characteristics of four groups were identical statistically. Interscalene block (Group ISB-IV, Group ISB-IL) was found to be effective at relieving pain and at reducing supplemental analgesic amounts at 1 and 8 hours postoperatively (p<0.05). Patients in the Group ISB-IL had less pain at 16 and 48 hours postoperatively than the other groups (p<0.05). Continuous intra-lesional infusion (Group IL, Group ISB-IL) was superior in reducing analgesic-related side effects (p<0.05). Conclusion: This study suggests that a combination of an interscalene brachial plexus block and continuous intralesional infusion of ropivacaine is an effective and safe method of postoperative pain control in patients after arthroscopic shoulder surgery.

A Study on the Experience of Clinical Practice and the Performance Confidence (치위생과 학생의 임상실습 경험정도와 수행자신감에 관한 연구)

  • Lee, Yeong-Ae;Kim, Young-Sun
    • Journal of dental hygiene science
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    • v.8 no.4
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    • pp.353-359
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    • 2008
  • To find out the relationship between the experience of clinical practice and the performance confidence, some 2nd and 3rd grade students in D health college who completed clinical practice in 2008. Sept. were surveyed. The results are as follows. 1. During the clinical practice of the dental hygiene students, the performance experience was highest in the basic prep. part among every part. As for the dental hygiene part, the students showed more than 70%, rather higher performance experience in the following parts: arrangement before and after treatment, suction, basic instruments setup, local anesthesia setup, extraction setup, resin filling setup, temporary filling setup, cements mixing, and ligation and removal setup. 2. As for performance confidence, those with performance experience showed higher performance confidence than those with only observation experience or with no experience in every treatment field except basic prep. (p < 0.001). 3. It was proven that the hygiene students have seldom had performance experience in other treatment parts except in assisting treatment part in clinical practice. In order to improve future performance experience on dental hygiene activities, subsequent research is needed to set more specific and objective criterion about the dental hygiene students' clinical practice.

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Stellate Ganglion Block and Electrical Acupuncture for Treatment of Allergic Rhinitis (성상신경절 차단과 전기침 자극에 의한 알레르기성 비염의 치료)

  • Kim, Jin-Seung;Jin, Sun-Mi;Cho, Sung-Kyung;Kim, Bong-Il;Lee, Sang-Hwa
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.208-212
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    • 1993
  • Allergy is one of the most common intractable disease, and also allergic rhinitis is the common symptom of the allergic diseases encountered in the otolaryngologic department. There are number of treatment such as: allergen avoidance by environmental control, pharmacotherapy, allergen immunotherapy and more. But choosing the exact reguired treatment is very difficult and troublesome. During the past 3 years, we have provided treatments to 49 allergic rhinitis patients with the combined therapy of stellate ganglion block(SGB) and eletrical acupuncture(E-AP) with very good results. From our experiences we highly recommend the combined therapy with SGB and E-AP for allergic rhinitis.

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THE STAINLESS STEEL CROWN RESTORATION OF CARIOUS PRIMARY MOLARS WITH HALL TECHNIQUE : A CASE REPORT (Hall technique을 이용한 우식 유구치의 기성 금속관 수복 : 증례보고)

  • Yu, Seong-Goo;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.199-205
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    • 2012
  • Although the stainless steel crowns have been recognized as the most effective and durable form of restoration for primary molars, they have been regarded by many dentists as having definite demerits such as invasive nature of procedural complexity and behavioral aspects of children. As an alternative to conventional technique of stainless steel crown restoration, the Hall technique was first introduced in 1988, which is characterized by just pushing the pre-contoured, cement filled crown form onto the abutment molar with no local anesthesia, no caries removal, no tooth preparation. According to several reports, this can slow, arrest, or even reverse the progress of caries. In addition, its atraumatic feature gives less discomfort and stress to children than conventional one, which is thought excellent especially in younger children. Also, It has been reported to be effective and acceptable to dentist, child patients and their parents. In this case study, three children with age of 4 years 5 months, 4 years 10 months, 6 years 4 months were treated with stainless steel crowns using Hall technique on first primary molar respectively. The teeth were free from pulpal, periapical pathology. After follow up of about 3 to 6 months period, the results showed clinically successful outcomes without any marked complication in pulp, tooth or soft tissue till now. But, it should be kept in mind that this technique is not proper to every child, every carious molar, or every dentist. Thorough distinction of indicated cases and continuous follow-up check is highly required. Conclusively, Hall technique might be an effective and realistic minimally invasive alternative for the carious primary molars especially in younger or disabled children, despite potential doubts on its efficacy and some definite limitations.

DIFFERENTIAL DIAGNOSIS BY JOINT CAVITY PUMPING WITH LOCAL ANESTHETIC FOR PAIN OF TEMPOROMANDIBULAR JOINT ARTHROSIS (악관절증의 동통에 대한 국소마취제의 관절강내 Pumping에 의한 감별법)

  • Chung, Hoon;Jung, Hak;Kino, Koji
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.146-153
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    • 1992
  • In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

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Clinical and Bacteriological Observation of 128 Cases of Chronic Otitis Media (중이수술 128례에 대한 임상적 세균학적 고찰)

  • 김광수;김정중;이계실;차인숙
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.19.2-19
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    • 1983
  • A Clinical and bacteriologcal observation was performed 128 cases of chronic otitis media who had taken middle ear surgery at Dept. of otolaryngology of St. Benedict Hospital during the period of Feb. 1981 to Feb. 1983. The following results were obtained. 1) Among total 128 cases, male were 60 cases (46.9%) and female were 68 cases (53.1 %) and age distribution showed 48 cases (37.5 %) in 3rd decade, 37 cases (28.9 %) in 2nd decade and 27 cases (21.1 %) in 4th decade. 2) Site distribution were 71 cases (55.5%) in right, 57 cases (44.5 %) in left. 3) Degree of preoperative hearing loss were 64 cases (50%) in moderate, 32 cases (25% ) in mild, 27 cases (21.1 %) in severe and 5 cases (3.9%) were normal. 4) Central perforation were observed in 65 cases (50.8 %), total perforation in 44 cases (34.4 %), attic perforation in 12 cases (9.4 %) and marginal perforation in 7 cases (5.4 %). 5) Pathologic changes of middle ear and mastoid antrum showed granulation in 81 cases (63.3 %), cholesteatoma in 47 cases (36.7%). 6) The route of approach were 123 cases (96.1%) in postauricular, 3 cases (2.3%) in transmeatal and 2 cases (1.6 %) in endaural. 7) Type of operation were 53 cases (41.4 %) in intact canal wall tympanoplasty with mastoidectomy, 42 cases (32.8 %) in tympanoplasty without mastoidectomy, 23 cases (18%) in modified radical mastoidectomy and 10 cases (7.8%) in radical mastoidectomy. 8) Type of anesthesia were 95 cases (74.2 %) by local anesthesia, 33 cases (25.8 %) were by general anesthesia. 9) Among 93 specimens of culture, proteus (31.2%), staphylococcus (28.7%), pseudomonas (23.7 %), streptococcus (7.5 %) and etc. (8.7%) in order of frequency.

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Assessment of Systemic Arterial Thromboembolism with Multi-Slice Spiral CT in a Dog (개에서 다중나선형 CT촬영에 의한 동맥혈전색전증의 평가)

  • Shin, Seung-Ho;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.208-213
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    • 2007
  • A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.