• The Journal of Korea Assosiation for Disability and Oral Health
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• 제15권1호
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• pp.1-6
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• 2019

There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

• The Journal of Korea Assosiation for Disability and Oral Health
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• 제10권2호
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• pp.61-67
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• 2014

The aim of this study was to analyze the clinical characteristics of patients with cognitive and behavioral impairments receiving dental treatment under general anesthesia (GA-dental treatment). From August 2007 to April 2014, information was collected from 475 patients who received GA-dental treatment at the Clinic for Persons with Disabilities, Seoul National University Dental Hospital. The demographic factors (gender, age, disability, medication, GA history, residency type, caregiver, meal type, oral hygiene maintenance, and cooperation level) and dental status (operating duration, DMFT, malocclusion, periodontal disease, tooth defect, and treatment protocol) of the patients were evaluated. DMFT and malocclusion levels were compared among the patients with ANOVA and Sheffe's post-hoc test, and chi-square test, respectively. The correlation between the demographic characteristics and dental status of the patients were analyzed with the Pearson's correction test. The mean age of the patients was 27.1 (7 - 83) years and they had intellectual disabilities (55.4%), developmental disorders (17.9%), brain disorders (16.6%), neurocognitive disorders (4.6%), or others (5.5%). The mean DMFT (DT) was 8.6 (5.2) with a significant difference among the disability types (p<0.05). The incidence of malocclusion was higher in patients with intellectual disabilities and brain disorders than in the other types (p<0.05). The operation time ($191.4{\pm}91.2min$) was correlated with decayed or endodontically-treated teeth (p<0.05). Special needs patients requiring GA-dental treatment showed unfavorable oral conditions. Dental practitioners experience time restrictions and additional costs under a GA setting. Treatment planning and decision-making can be efficiently facilitated by evaluating the clinical characteristics of the patients.

• Journal of the korean academy of Pediatric Dentistry
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• 제45권4호
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• pp.508-513
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• 2018

Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

• The Journal of Korea Assosiation for Disability and Oral Health
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• 제2권2호
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• pp.136-141
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• 2006

The purpose of this study is to survey the status of oral care of adult patients with disabilities and satisfaction degree of outpatient general anesthesia for dental treatment. 30 adult patients who underwent general anesthesia for dental treatment at clinic for the disabled in Seoul National University Dental Hospital enrolled for telephone survey. Many patients (83.3%) had mental problems to do social communication. And someone of family members (mainly mother) had cared for the patient but there was only one patient who got regular oral care. The satisfaction level of outpatient general anesthesia and nursing care for dental treatment was very high(100%).

• International Journal of Advanced Culture Technology
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• 제6권4호
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• pp.158-164
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• 2018

The object of this study is to explore the attitudes of occupational therapy students and "general students" (who study in different areas other than occupational therapy) towards people with disabilities, and to examine the causing factors of positive and negative attitudes toward people with disabilities by using Disability Factor Scales (DFS). According to the result of the study using the Disability Factor Scales (DFS), it indicates that the attitudes of the occupational therapy students were more positive than those of "general students" from other departments. In the case of score differences among occupational therapy students by class standing, seniors who experienced clinical practice showed a less favorable attitude toward the disabled than freshmen, so it is necessary to develop clinical practice and an occupational therapy curricula that incorporate patient-centered treatment rather than therapist-centered education with simple physical contact or illness problems.

• Journal of Acupuncture Research
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• 제32권3호
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• pp.197-202
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• 2015

Objectives : The purpose of this study is to report on the residual symptoms after decompression of traumatic compartment syndrome experienced by a patient whose condition was much improved by electroacupuncture and bee venom therapy. Methods : The patient was treated with electroacupuncture and bee venom therapy. The progress of symptoms was checked by visual analog scale, disabilities of the arm, shoulder, and hand(DASH) and range of motion. Results : All results were improved. Scores from the visual analog scale and DASH decreased, while the range of motion increased. Conclusions : Electroacupuncture and bee venom therapy have an effect on residual symptoms after decompression of traumatic compartment syndrome.

• The Journal of Korea Assosiation for Disability and Oral Health
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• 제10권2호
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• pp.97-100
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• 2014

We experienced a case of dental treatment under general anesthesia in a 22-year-old female patient with dysphagia and dental phobia following partial glossectomy. She was diagnosed of squamous cell carcinoma of tongue and received surgical, radiation treatment two years ago. We report the experiences of anesthetic management for dental treatment in a patient with dysphagia and dental phobia following partial glossectomy.

• Physical Therapy Korea
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• 제11권4호
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• pp.43-49
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• 2004

It is not common in rehabilitation situation to encounter patients exhibiting paralysis or other disabilities which have no apparent organic basis. Even without organic causes for their signs and symptoms these patients often require comprehensive treatment and management. Patients with conversion disorder often pose particular difficulties because of diagnostic confusion and the lack of therapeutic strategies for rehabilitation management. We feel that systematic functional rehabilitation is helpful in resolving symptom and recovering normal function in the patient suffering from conversion disorder since it provides motivation and reduces reinforcements which contribute to sustained disabled state. This report describes the patient with hysterical motor paralysis who is successfully treated with structured physical therapy. The objectives of this report are to provide therapeutic guidelines for physical therapy and to emphasize the role of physical therapist in the assessment and treatment of hysterical paralysis.

• Journal of The Korean Dental Society of Anesthesiology
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• 제8권1호
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• pp.22-28
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• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제4권1호
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• pp.87-101
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• 1997

This Research is an attempt to find out what effects the resistance exercise program has on the rheumatoid arthritis patient's functional disability and biochemical parameters. The research took place from June to November 1996, and the target included an experimental group of 25 cases of rheumatoid arthritis and a control group of 26 cases of rheumatoid arthritis taken from the Anam Medical Center at Korea University. The resistance exercise program was executed on these patients five times a week during a period of eight weeks. Before and after the experiments, measurements of functional disability score, ESR, CRP, self-efficacy, and family support were taken and closely analysed. The results of this analysis are as follows : 1. After the experiment, the experimental group had less functional disabilities compared to the control group(t=9.11, P=0.0017). 2. After the experiment, the ESR of both the experimental and the control groups decrease, but there was not notable difference between the two groups(t=0.07, P=0.9546). 3. After the experiment, the CRP of both the experimental and the control groups decreased, with no significant different between them(t=0.53, P=0.6022). 4. After the experiment, the self-efficacy of the experimental group increased significantly compared to the control group(t=3.15, P=0.0042), but the self-efficacy had no effect on the actual practice of the program. 5. After the experiment, the family support of the experimental group was higher than of the control group(t=6.33, P=0.0013), but again the family support had no effect on the actual practice of the program. Judging from the results of these experiments, the resistance exercise program not only diminishes rheumatoid arthritis patients' functional disabilities, but also has a great influence on increasing their self-efficacy and family support. Concluding, in diminishing the functional disabilities of rheumatoid arthritis, the resistance exercise program would be appropriate nursing intervention.