• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.30-35
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• 2009

Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through $\gamma$-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam, may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.

• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.2 s.5
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• pp.87-91
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• 2003

Background: The purpose of this study was to compare the availability of propofol and fentanyl (P + F) with diazepam and morphine (D + M) for intravenous conscious sedation during third molar surgery. Methods: Forty patients without systemic disease were operated under IV conscious sedation administered by either of the two techniques. Monitoring consisted of continuous observation of pulse rate, blood pressure, oxygen saturation, and the respiratory rate and were recorded every 15 minutes. Cooperation score was measured 5 and 15 minutes after induction of IV sedation. Following the operation, the surgeon and patients completed questionnaires including pain visual analog scale, amnesia, and side effects. Results: The P + F group was significantly more cooperative than the D + M group. The side effects of D + M group included pain on injection, nausea/vomiting and abdominal pain. The side effects of P + F group included talkativeness, nausea/vomiting, temporary apnea, pain on injection and vertigo. Conclusions: In this study, there were following benefits in the P + F group; more cooperative status and less pain perception. But respiratory depression developed in some patients.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.203-208
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• 2010

Tremors are trembling movements and are seen in association with alcoholic intoxication, certain drugs, thyrotoxicosis, multiple sclerosis, hysteria, and nervous tension. Dental fears, such as, pain, drill, unknown, dependency, helplessness, mutilation and oral change, induce the neuroendocrine response (release of epinephrine and norepinephrine, etc). The clinical manifestations of epinephrine or other vasopressor overdose include : anxiety, tenseness, restlessness, throbbing headache, tremor, perspiration, weakness, dizziness, pallor, palpitation and respiratory difficulty. Signs of local anesthetic overdose appear clinically whenever the anesthetic level in the blood rises to an appropriate level in an individual. The clinical signs of moderate overdose levels include : talkativeness, apprehension, excitability, slurred speech, tremor and muscular twitching. This is a case report about the severe tremor care after the endodontic treatment under right mandibular block anesthesia in a 56-years old female patient.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.4
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• pp.982-989
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• 2004

The following is the conclusion drawn from a review on the clinical cases cured by Jaeumkangwha-tang in perspective of Hyungsang medicine. Jaeumkangwha-tang originated from the modified Jibaiksamul-tang in 'Manbyunghuichun(萬病回春)' and applied to the diseases induced by flaming fire due to deficiency of Yin. In 'Donguibogam', there are two kinds of Jaeumkangwha-tang. One in the chapter of kidney is mainly prescribed to replenish the Jung of kidney and applicable to the cases with configuration and symptom of kidney along with fire. The other one in the chapter of fire is applied to the symptoms of flaming fire due to deficiency of Yin. The characteristics of the patients treated by Jaeumkangwha-tang from the viewpoint of Hyungsang medicine can be classified as follows : ① configuration: Dam type, Shin type, inverted triangular type(:天垂象), bird type, round eyes, thin lips, slender waist, thin leg, pretty face, sparkling eyes, prominent upper lip and upward eyes and nose. ② color : dark red complexion, red cheek bone, red lips and red glabella. ③ pulse : fine and fast pulse and pulsation on the Chuk(尺) in man and so forth. ④ symptoms: agility, talkativeness, pimpled face, crooked back, weakness to the heat of summer, light eating, timidity, blood-shot eyes, night sweat, cough, abundant phlegm, hemoptysis, bloody spittle, enervation, emaciation, back pain, flaccidity of lower limbs, involuntary emission, nocturnal emission, heat sensation in the chest palms and soles, anger, flush on cheek bone, red lips and dry mouth, reddish tongue, stiff excrement, scanty yellow urine, etc.

• Journal of The Korean Dental Society of Anesthesiology
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• v.1 no.1 s.1
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• pp.26-31
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• 2001

The wide deep penetrating wound of maxillofacial region should be early closed under emergency general anesthesia for the prevention of complications of bleeding, infection, shock & residual scars. But, if the emergency general anesthesia wound be impossible because of pneumoconiosis, obstructive pulmonary disease & hypovolemic shock, early primary closure should be done under local anesthesia by use of much amount of the anesthetic solution. The maximum dose of dental lidocaine (2% lidocaine with 1 : 100,000 epinephrine) is reported to 7 mg/kg under 500 mg (13.8 ampules) in normal adult. But the maximum permissible dose of dental lidocaine can be changed owing to the general health, rapidity of injection, resorption, distribution & excretion of the drug. The blood level of overdose toxicity is above $4.0{\mu}g/ml$ in central nervous & cardiovascular system. The injection of dental lidocaine 1-4 ampules is attained to the blood level of $1{\mu}g/ml$ in normal healthy adult. The duration of anesthetic action in the dental 2% lidocaine hydrochloride with 1 : 100.000 epinephrine is 45 to 75 minutes and the period to elimination is about 2 to 4 hours. Therefore, authors selected the following anesthetic methods that the first injection of 6 ampules is applied into the deeper periosteal layer for anesthetic action during 1 hour, the second injection into the deeper muscle & fascial layer, the third injection into the superficial muscle and fascial layer, the fourth injection into the proximal skin & subcutaneous tissue and the fifth final injection into the distal skin & subcutaneous tissue. The total 26-28 ampules of dental lidocaine were injected into the wound as the regular time interval during 5-6 hours, but there were no systemic complications, such as, agitation, talkativeness, convulsion and specific change of vital signs and consciousness.

• Journal of Digital Convergence
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• v.19 no.1
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• pp.361-371
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• 2021

Communication education research has focused on the effects of instructor characteristics on learning. It is necessary to consider student characteristics as well to develop an effective teaching strategy. The current study tries to classify students into multiple distinct groups depending on their personality traits and communication characteristics and investigates differences in effects of teacher characteristics between those groups. A survey on unversity students was conducted to collect data. A cluster analysis was carried out to identify distint sub-groups of respondents by their personality traits and communication characteristics. The analysis yielded two distinct groups. The two groups were named stable-reticent group', and 'neurotic-talkative group' respectivley. Series of multiple regression were carried out in order to investigate differences in the effects of instructor characteristics. The analyses found different patterns of effects between the two sub-groups. The findings suggest that it is necessary to adopt different communication styles and teaching strategies depending on student types.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.164-169
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• 1999

Background and Objectives : The intracordal cysts are more increasingly diagnosed and treated due to advanced laryngeal stroboscopy and laryngeal microsurgical technique. The intracordal cysts are frequently misdiagnosed as vocal polyp or nodule The purpose of this study is to evaluate clinical features of intracordal cysts. Materials and Methods : In the present series, 83 cases of the intracordal cysts treated with laryngeal microsurgery are reported. The intracordal cysts are diagnosed preoperatively with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with laryngeal microsurgical findings and biopsies. Results : Intracordal cysts are 83 of 1900 patients treated with laryngeal microsurgery(4.4%)-ductal cysts are 56 cases and epidermoid cysts are 27 cases. Intracordal cysts are more frequent in women, forties and the frequent site is an anterior third of the true vocal cord. With the indirect laryngoscopic examination, the ductal cysts are frequently misdiagnosed as vocal polyps or nodules but the epidermoid cysts are relatively easily diagnosed. The etiologic factors of the intracordal cysts are suspected as voice abuse and upper respiratory infection. The degree of postoperative voice satisfaction is similar to that of the vocal polyps. Conclusion : Intracordal cysts are frequently misdiagnosed as polyps or nodules, therefore preoperative stroboscopic findings and laryngeal microsurgical findings is important. An ideal treatment is to enucleate the cysts avoiding rupture of cyst and injury of lamina propria of the vocal cord.