• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.361-367
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• 2019

Background: Although studies on dental fear in relation to sex and age have been conducted, there have been few nationwide studies particularly on the youth sector. In addition, no validity and reliability verifications have been implemented for new research groups on the Korean version of the Dental Fear Survey (K-DFS). Therefore, this study aimed to apply the K-DFS developed in a previous study on Korean youth to draw conclusions on dental fear among the youth. Methods: This study used the K-DFS, a Korean translation of Kleinknecht's Dental Fear Survey for elementary school, middle school, and high school students. This study selected 2,161 young people of various ages as participants and increased the validity of the research results by expanding nationwide the scope of the study area. Results: Differences in fear levels according to sex were higher in boys fear behavior scores than in girls' regarding dental treatment (P < 0.05). Students with dental fear had higher scores on items associated with dental treatment and fear of dental stimuli compared with students without dental fear (P < 0.05). Differences were observed among the three groups (P < 0.05). However, the results of logistic regression analysis showed no statistically significant differences for dental visits based on sex, grade, and other subcomponents (P > 0.05). Conclusion: By verifying the validity of the newly developed K-DFS, this research confirmed its utility as a dental fear questionnaire. Therefore, there can be no objection that the grounds for criticism have been established according to conventional wisdom. In the future, however, developing and studying the limits of K-DFS that overcome the factors of dental fear, especially pain, will help reduce dental fear in adolescents.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.267-269
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• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.800-803
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• 2002

A two year old male child complained of foreign body sensations bilaterally, and an itching sensation at both upper and lower eyelids for 2 months of duration. He was diagnosed with Phthiriasis palpebrarum after observation of adult louse and nits on slit-lamp examination. The treatment was accomplished by mechanical removal of the lices and nits by forceps and scissors, and then irrigation with 20% fluorescein was done under general anesthesia. Antibiotic eyedrops and ointment were applied to both eyes. The morphologic evaluation was performed with light microscopy and scanning electron microscopy. The follow-up interval was every weeks for one month and no louse or nit was found under slit-lamp examination. So we concluded that the Phthiriasis palpebrarum was eradiated completely. We report a case of Phthriasis palpebrarum had been review of the literatures.

• Journal of Sensor Science and Technology
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• v.29 no.4
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• pp.249-254
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• 2020

It is difficult to control children who exhibit negative behavior in dental clinics. Various methods are used for preventing pediatric dental patients from being afraid and for eliminating the factors that cause psychological anxiety. However, when it is difficult to apply this routine behavioral control technique, sedation therapy is used to provide quality treatment. When the sleep anesthesia treatment is performed at the dentist's clinic, it is challenging to identify emergencies using the current breath detection method. When a dentist treats a patient that is under the influence of an anesthetic, the patient is unconscious and cannot immediately respond, even if the airway is blocked, which can cause unstable breathing or even death in severe cases. During emergencies, respiratory instability is not easily detected with first aid using conventional methods owing to time lag or noise from medical devices. Therefore, abnormal breathing needs to be evaluated in real-time using an intuitive method. In this paper, we propose a method for identifying abnormal breathing in real-time using an intuitive method. Respiration signals were measured using a 3M Littman electronic stethoscope when the patient's posture was supine. The characteristics of the signals were analyzed by applying the signal processing theory to distinguish abnormal breathing from normal breathing. By applying a short-time Fourier transform to the respiratory signals, the frequency range for each patient was found to be different, and the frequency of abnormal breathing was distributed across a broader range than that of normal breathing. From the wavelet transform, time-frequency information could be identified simultaneously, and the change in the amplitude with the time could also be determined. When the difference between the amplitude of normal breathing and abnormal breathing in the time domain was very large, abnormal breathing could be identified.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.205-221
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• 2018

This systematic review aimed to analyze the efficacy of corticosteroid premedication compared to placebo or no treatment to reduce postoperative pain in endodontic patients. Randomized controlled trials (RCTs) assessing corticosteroids via oral, intramuscular, subperiosteal, intraligamentary or intracanal route compared to passive or active placebo, or no treatment were included. Four databases were searched: PubMed, Web of Science, Cochrane Library and Embase up to 2/21/2018. Risk of bias was assessed with Cochrane Risk of bias tool. Fourteen RCTs with 1,462 generally healthy adults in need of endodontic treatment were included. 50% of the studies were at unclear risk and 50% at high risk of bias. Meta-analysis showed Visual Analog Scale (VAS) pain at 4-6 hours after Inferior Alveolar Nerve Block (IANB) was significantly lower by 21 points (0-100 scale) in the corticosteroid group compared to the control group (95% CI -35 to -7; P = 0.003), however this difference was not statistically significant after 24 hours (P = 0.116). The route of administration was oral and intraligament injection. Patients who received corticosteroids prior to IANB were 70.7% more likely to have none or mild pain 4-8 hours after treatment (P = 0.001) and 13.5% more likely 24 hours after IANB (P = 0.013) than patients in the control group. In conclusion, corticosteroid administration (oral or intraligamental) may clinically reduce the level of postoperative pain at 4-8 hours after IANB, however the quality of the evidence was low/moderate due to risk of bias and heterogeneity. Further studies are recommended.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.43-45
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• 2017

Pneumoparotid is defined as the presence of air within the parotid gland or duct. Pneumoparotid is an extremely rare cause of parotid gland swelling. Pneumoparotid can be induced by air insufflation from oral cavity into the intraparotid salivary ducts, in condition like nose blowing, blowing up balloons, during extubation after general anesthesia while receiving positive pressure, rapid decompression while scuba diving, chronic attempts to suppress cough, and glassblowers. It can also be self-induced, and the literature contains an increasing number of reports involving pediatric and adolescent patients who induce parotid insufflation to avoid school or gain attention. Here, we report a case of pneumoparotid caused by habitual cheek inflating and improved with conservative treatment.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.54-56
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• 2012

Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.85-92
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• 2015

Background: Many people experience varying levels of discomfort when confronted with the prospect of dental treatment. Dental treatment can be a traumatic experience, especially for children and adolescents with dental anxiety. In this age group, dental fear causes a significant problem in dental management and has been related to severe dental caries and dental pain. The Dental Fear Survey (DFS) is the most widely used measure of dental fear. This study was undertaken to develop the Korean version of the DFS (K-DFS) and test its reliability and validity. Methods: The K-DFS, which uses projective techniques to measure children's and adolescents' dental fear, was developed. The DFS was translated into Korean and participants were selected via convenience sampling. Reliability and validity were tested using data from a sample of 813 middle school students in Gyeonggi Province, selected from the Self questionnaire survey. The K-DFS was administered twice to 102 adolescents aged 12-15 years. Results: The K-DFS had high internal consistency reliability (99.1%) but low test-retest reliability. Conclusions: The results indicate that the Korean versions of the DFS have good internal consistency reliabilities and test-retest validities. However, we need to further examine the test-retest reliability of the K-DFS and replicate the current study in different samples covering various age groups.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.97-103
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• 2018

Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. Methods: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Results: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). Conclusions: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.129-142
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• 2018

Introduction: This systematic review evaluated the use of buffered versus non-buffered lidocaine to increase the efficacy of inferior alveolar nerve block (IANB). Materials and Methods: Randomized, double-blinded studies from PubMed, Web of Science, Cochrane Library, Embase, and ProQuest were identified. Two of the authors assessed the studies for risk of bias. Outcomes included onset time, injection pain on a visual analog scale (VAS), percentage of painless injections, and anesthetic success rate of IANB. Results: The search strategy yielded 19 references. Eleven could be included in meta-analyses. Risk of bias was unclear in ten and high in one study. Buffered lidocaine showed 48 seconds faster onset time (95% confidence interval [CI], -42.06 to -54.40; P < 0.001) and 5.0 units lower (on a scale 0-100) VAS injection pain (95% CI, -9.13 to -0.77; P=0.02) than non-buffered. No significant difference was found on percentage of people with painless injection (P = 0.059), nor success rate (P = 0.290). Conclusion: Buffered lidocaine significantly decreased onset time and injection pain (VAS) compared with non-buffered lidocaine in IANB. However due to statistical heterogeneity and low sample size, quality of the evidence was low to moderate, additional studies with larger numbers of participants and low risk of bias are needed to confirm these results.