Background: The purpose of this study was to analyze the equality between key words used in the Journal of Korean Dental Society of Anesthesiology and Medical Subject Headings (MeSH). Methods: A total of 666 English key words in 187 papers (average 3.5 words in a paper) from 2001 to 2014 were eligible for this study. We classified them according to matched, and non-matched terms. After descriptive analysis, we assayed patterns of errors in using MeSH, and reviewed frequently used non-MeSH terms. Results: Fifty nine point six percent (59.6%) of total key words were completely coincident with MeSH terms, 40.39% were not MeSH terms. Conclusions: The results show that the coincidence rate of key words with MeSH terms was at a moderate level. However, there is a need for us to understand MeSH more specifically and accurately. Use of proper key words aligned with the international standards such as MeSH is important to be properly cited. The authors should pay attention and be educated on correct use of MeSH as key words.

Background: Dexmedetomidine is known to be administered for sedation safely even in a very elderly patient. The purpose of this study was to determine the effect of age on clinically optimal dose of dexmedetomidine for sedation. Methods: We enrolled 50 patients ASA class I and II, scheduled for lower extremity surgery that need. They were classified into a young group (n = 26), aged below 75 and an old group (n = 24), aged above 75. Dexmedetomidine was continuously infused $0.5{\mu}g/kg$ within 10 min, followed by maintenance at a dose of $0.5{\mu}g/kg/min$, initially. The next dose was selected using the Dixon's up-and-down method. Results: The cED50 of dexmedetomidine required to maintain optimal sedation level in young and old group were 0.50 and $0.48{\mu}g/kg$, respectively. With isotonic regression, cED95 of dexmedetomidine was $0.71{\mu}g/kg$ (95% confidence intervals $0.57-1.06{\mu}g/kg$) and $0.58{\mu}g/kg$ (95% confidence intervals $0.51-0.67{\mu}g/kg$). There were no significant differences in cED50 (P = 0.21), recovery variables, or incidence of side effects between the two groups. Conclusions: Clinically optimal dose of dexmedetomidine was not affected to the age during sedation.

Background: Incisional site of surgical operation become transient ischemic state and then occur reoxygenation due to vasodilatation by inflammatory reaction, the productive reactive oxygen species (ROS) give rise to many physiologic results. Apoptosis have major role on elimination of inflammatory cell and formation of granulation tissue in normal wound healing process. Remifentanil can prevent the inflammatory response and can suppress inducible nitric oxide synthase expression in a septic mouse model. After cardiopulmonary bypass for coronary artery surgery, remifentanil can also inhibit the release of biomarkers of myocardial damage. Here we investigated whether remifentanil pretreatment has cellular protective effect against hypoxia-reoxygenation in HaCaT human keratinocytes, if so, the role of apoptosis and autophagy on this phenomenon. Methods: The HaCaT human keratinocytes were exposed to various concentrations of remifentanil (0.01, 0.05, 0.1, 0.5 and 1 ng/ml) for 2 h before hypoxia (RPC/HR group). These cells were cultured under 1% oxygen tension for 24h at $37^{\circ}C$. After hypoxia, to simulate reoxygenation and recovery, the cells were reoxygenated for 12 h at $37^{\circ}C$. 3-MA/RPC/HR group was treated 3-methyladenine (3-MA), autophagy inhibitor for 1h before remifentanil treatment. Cell viability was measured using a quantitative colorimetric assay with thiazolyl blue tetrazoliumbromide (MTT, amresco), showing the mitochondrial activity of living cells. To investigate whether the occurrence of autophagy and apoptosis, we used fluorescence microscopy and Western blot analysis. Results: The viability against hypoxia-reoxygenation injury in remifentanil preconditioning keratinocytes were increased, and these cells were showed stimulated expression of autophagy 3-MA suppressed the induction of autophagy effectively and the protective effects on apoptosis. Atg5, Beclin-1, LC3-II and p62 were elevated in RPC/HR group. But they were decreased when autophagy was suppressed by 3-MA. Conclusions: Remifentanil preconditioning showed the protective effect in human keratinocytes, and we concluded that autophagy may take the major role in the recovery of wound from hypoxia-reoxygenation injury. We suggest that further research is needed about the cell protective effects of autophagy.

Background: Propofol is the most commonly used anesthetic for sedation and target-controlled infusion (TCI) is useful for dental treatment. However, it is important to assess and maintain an adequate depth of sedation in patients with severe intellectual disabilities Therefore, in this study we aimed to evaluate the adequate propofol target concentration for dental treatment in severely intellectually disabled patients. Methods: We undertook retrospective review of the sedation records of severely intellectually disabled patients who underwent dental treatment under TCI propofol sedation from September 2011 to April 2012. We evaluated the initial target concentration, stabilized concentration of propofol and monitored vital signs, including BIS score using sedation records. Results: Total 20 patients (10 male and 10 female patients) were included in the study. Every participant was severely intellectually disabled. The mean sedation duration was $70{\pm}16$ (45-100) minutes. The initial propofol target concentration infusion amount was $2.7{\pm}0.45$ (2.0-3.0) mcg/ml. The propofol effect site concentration (Ce) was $2.6{\pm}0.7$ (1.0-4.0) mcg/ml. The average value of BIS was $52.6{\pm}13$ (28-81). During the treatment period, there were no severe complications. Conclusions: The average propofol Ce for deep sedation without any complications in intellectually disabled patients was 2.6 mcg/ml.

Atypical facial pain is loosely used term to describe some chronic facial pain when the symptoms do not exactly and entirely fit one diagnostic criteria. In many cases of pain disorders, sympathetic system is involved, such as in conditions which symptoms mimic post-herpetic neuralgia or complex regional pain syndrome. We report a case of a patient with atypical facial pain following the reduction of temporomanidbular joint dislocation. The atypical pain which was resistant to analgesic medication was successfully managed with stellate ganglion block. Therefore we suggest that stellate ganglion block can be an effective treatment method for controlling atypical facial pain.