• 대한장애인치과학회지
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• 제6권2호
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• pp.84-93
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• 2010

The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.246-249
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• 1998

본 증례는 우측 하악 후구치부위에 생긴 편평상피세포암종의 절제후 생긴 결손부를 미세혈관수술을 이용한 유리전완피부피판으로 재건한 증례로서 병소가 발생한 해부학적 위치 및 절제 후 생긴 결손부의 크기를 고려할 때, 전완피부피판을 이용하여 재건하였으며 현재까지 양호한 결과를 보이고 있다. 이와 같이 전완피부피판은 특성을 잘 이용하는 적절한 적응증에 사용된다면 어떤 다른 재건방법 보다도 성공적인 결과를 가져올 수 있으며 특히 구강악안면영역의 재건에서 그 효용성이 크다고 할 수 있다.

• The Korean Journal of Pain
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• 제33권2호
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• pp.138-143
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• 2020

Background: Severe pain associated with proximal femur fractures makes the positioning for regional anesthesia a challenge. Systemic administration of analgesics can have adverse effects. Individually, both the fascia iliaca block (FIB) and femoral nerve blocks (FNB) have been studied. However, there is little evidence comparing the two. The aim of this study was to compare the overall efficacy of the two blocks in patients with proximal femur fracture before positioning for spinal anesthesia. Methods: ASA (American Society of Anesthesiologists) class I, II, and III patients scheduled for elective and emergency surgery with the diagnosis of proximal femur fracture between October 2018 and June 2019 were included in the study. The patients were assigned to two groups by convenience nonprobability sampling of 35 each. Results: Our study showed a reduction in visual analogue scale scores at 3, 4, and 5 minutes after administration of the FIB being 5.1 ± 1.1, 4.1 ± 1.3, and 2.8 ± 0.8, and those after the FNB as 4.4 ± 1.1, 3.3 ± 1.1, and 2.1 ± 1.4 with P < 0.05, which was statistically significant. The mean first rescue analgesia time for the FIB was 7.1 ± 2.1 hours, while for the FNB it was 5.2 ± 0.7 hours. The P value was less than 0.001, which was significant. Conclusions: Both ultrasound guided FNB and FIB techniques provide sufficient analgesia for patient's positioning before spinal anesthesia. However, the duration of postoperative analgesia provided by FIB was greater than that of the FNB.

• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.291-302
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• 2002

In most of the previous studies, invasive and discrete techniques have been used to monitor the healing process of the gingival graft. However, Laser Doppler Flowmetry(LDF, floLAB(R), Moor Instruments Ltd., England) is a non-invasive technique for measurement of blood flow in the tissue and also allows continuous monitoring. Thus, we tested the usefulness of LDF in monitoring the healing process of free gingival graft at gingival recession. Eleven gingival graft site of 7 patients, including 5 males and 2 females, aged between 21 and 41 years (mean age 28.5) were monitored for the blood flow. The blood flow in gingival graft at coronal site, central site, apical site, mesial site and distal site was measured using LDF. Blood flow was measured at 1- week, 2- week, 3- week and 4- week after gingival graft surgery from 10 a.m. to 2 p.m. Time-course of the healing process was evaluated by statistical analysis using repeated ANOVA and Duncan test. The results were as follows : (1) Blood flow stayed increased for 2 weeks, and then, it was a tendency to decrease. (2) The blood flow at distal site had always higher than mesial site during the measuring periods. (3) The blood flow was high orderly after 1 week ; most coronal site, most apical site, central site. But that was high orderly after 2 week, 3 week, 4 week ; most coronal site, central site, most apical site. In conclusion, LDF was a useful and clinically adaptable method to monitor wound healing process. Our study suggested that it was important to protect surgical site to promote initial wound healing.

• Journal of Periodontal and Implant Science
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• 제33권4호
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• pp.705-715
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• 2003

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권2호
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• pp.83-87
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• 2020

Foreign body (FB) ingestion is commonly seen in the ear nose and throat (ENT) field, with different presentations and sequelae. FBs can arrest in the upper aerodigestive tract or continue further down into either the airway tract to the bronchus or the digestive tract to the intestines. The pathway of an FB depends on the size and shape of the FB and how sharp its edges are. Since the 20th century, the use of disposable stainless-steel needles in the oral cavity has proven to be an effective and safe method for performing various intraoral procedures like dental infiltration or a root canal wash. Complications from their use are rare. Generally, dental needle breakages are caused by patients biting the needle, incorrect injection techniques, or inadequate preventative measures. The sudden movement of a patient during a procedure is one of the most common causes of breakage. Occasionally, needles are swallowed during dental procedures such as a root canal. Here, we report a case of a patient that swallowed a broken needle during a dental procedure. A few days later, the patient presented with neck pain, swelling, and a FB sensation. When the patient presented, she claimed that her symptoms had onset after consuming a meal containing duck meat. Initially, the patient was diagnosed as having ingested a duck bone. However, intraoperatively, the FB was discovered to be an injection needle that had migrated from the throat to the neck.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.77-81
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• 2008

회전근 개 파열에 대한 봉합 수술의 목적은 봉합 초기에 고정력을 높이고 건-골 사이의 간격 형성을 최소화 하며 반복적인 부하에 기계적인 안정성을 유지시키고 회전근 개의 끝이 뼈에 부착되어 치유될 때까지 건-골 사이의 치유 환경을 최적화시키는 것이다. 일열 봉합은 원래의 회전근 개 부착부에 건을 완전히 부착시키는 면적이 제일 적고 간격 형성에 취약하다. 이열 봉합은 고정 실패를 방지하는 힘이 일열 봉합보다는 우수하고 간격 형성도 더 적으며 교량형 봉합은 최대 인장력이 가장 크며 전단력 및 회전력에 강하고 간격 형성도 제일 적다. 이러한 것을 볼 때 이열 봉합 및 교량형 봉합이 일열 봉합보다 우수한 점이 많지만 수술 시간이 좀 더 오래 걸리고 삽입하는 나사못의 개수도 많아 수술료가 비싸다는 단점도 가지고 있다. 따라서 일열 봉합도 회전근 개의 점액 낭측 부분층 파열이나 작은 완전 파열에 쓰여질 수 있는 아직은 유용한 방법으로 사료된다.

• The Korean Journal of Pain
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• 제13권1호
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• pp.84-88
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• 2000

Background: An increase in the maximum level of sensory blockade (MLSB) following an epidural top-up in combined spinal epidural anesthesia (CSE) may be achieved by a volume effect as the volume of local anesthetic compresses the dural sac, by a local anesthetic effect, or by a combination of both effects. This study was conducted to investigate the contribution of each of these effects. Methods: Sixty patients scheduled for lower limb surgery under CSE were randomly allocated to one of three groups of twenty patients each. Using the needle-through needle technique, all patients received a subarachnoid dose of 10 mg hyperbaric 0.5% bupivacaine. At 30 min after subarachnoid injection, an epidural top-up with saline 10 ml (group II) or 0.5% bupivacaine 10 ml (group III) was administered; patients in group I received no epidural top-up. The level of sensory blockade was assessed at 5, 10, 15, 20, 25, 30 min after subarachnoid injection and at 5, 10, 15, 20, 25, 30 min after epidural top-up. Results: There was no significant difference in the MLSB and the onset time of MLSB among group I-III. Conclusions: We concluded that the epidural top-up with saline 10 ml or 0.5% bupivacaine 10 ml which injected at 30 min after subarachnoid injection did not significantly increase the level of subarachnoid block in lower extremity surgical patients.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.325-333
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• 2012

Objective : The indications and optimal surgical treatments for intracranial cysts are controversial. In the present study, we describe long-term clinical and neuroimaging results of surgically treated intracranial cysts in children. The goal of this study is to contribute to the discussion of the debate. Methods : This study included 110 pediatric patients that underwent surgeries to treat intracranial cysts. Endoscopic cyst fenestrations were performed in 71 cases, while craniotomies and cyst excisions (with or without fenestrations) were performed in 30 patients. Cystoperitoneal shunts were necessary for nine patients. Long-term results were retrospectively assessed with medical and neuroimaging records. Results : Clinical and radiological improvement was reported in 87.3% and 92.8% of cases, respectively, after endoscopic neurosurgery, and in 93.3% and 100% using open microsurgery whereas 88.9% and 85.7% after shunt operation. There were no statistical differences in clinical outcomes (p=0.710) or volume reductions (p=0.177) among the different surgeries. There were no mortalities or permanent morbidities, but complications such as shunt malfunctions, infections, and subdural hematomas were observed in 56% of the patients that had shunt operations. A total of 13 patients (11.8%) underwent additional surgeries due to recurrences or treatment failures. The type of surgery performed did not influence the recurrence rate (p=0.662) or the failure rate (p=0.247). Conclusion : Endoscopic neurosurgeries are less invasive than microsurgeries and are at least as effective as open surgeries. Thus, given the advantages and complications of these surgical techniques, we suggest that endoscopic fenestration should be the first treatment attempted in children with intracranial cysts.

• 대한방사선기술학회지:방사선기술과학
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• 제41권5호
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• pp.413-419
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• 2018

Magnetic Resonance Imaging for patients with metallic implant has poor image quality, and signal loss and artifacts including distortion can occur. The purpose of this study is to carry out a comparative evaluation on high receive bandwidth(hiBW), O-MAR, O-MAR XD to reduce artifacts in knee implant. To take MRI, 3.0T scanner and dual-source radiofrequency transmission were used. O-MAR XD technique's strong option showed a significant difference (p<0.001) with O-MAR XD technique's weak option, O-MAR and hiBW excluding the medium option. O-MAR XD's medium option had a significant difference (p<0.01) with O-MAR XD's weak, O-MAR and hiBW. O-MAR XD technique's weak option had a significant difference (p<0.01) with O-MAR XD's strong and medium options, O-MAR and hiBW. O-MAR technique had a significant difference (p<0.001) with strong, medium, weak options of O-MAR XD technique except for hiBW. HiBW had a significant difference (p<0.001) with strong, medium and weak options of O-MAR XD technique except for O-MAR. The results showed that O-MAR XD technique was more useful for MRI scan for patients with knee replacement surgery than traditional techniques such as hiBW or O-MAR, and susceptibility artifacts decreased more when O-MAR XD technique's strong or medium option was applied. Based on the results above, it is considered that it will be possible to acquire images whose susceptibility artifacts were highly decreased by using O-MAR XD technique's strong or medium option when conducting MRI for artificial knee joint and it will be helpful for checking and monitoring patients with knee joint replacement.