• Title/Summary/Keyword: 부위마취

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Autometallography for Zinc Detection in the Central Nervous System (중추신경계통내 분포하는 Zinc의 조직화학적 동정)

  • Jo, Seung-Mook;Gorm, Danscher;Kim, Sung-Jun;Park, Seung-Kook;Kang, Tae-Cheon;Won, Moo-Ho
    • Applied Microscopy
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    • v.30 no.4
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    • pp.347-355
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    • 2000
  • Zinc is one of the most abundant oligoelements in the living cell. It appears tightly bound to some metalloproteins and nucleic acids, loosely bound to some metallothioneins or even as free ion. Small amounts of zinc ions (in the nanomolar range) regulate a plentitude of enzymatic proteins, receptors and transcription factors, thus rolls need accurate homeostasis of zinc ions. Zinc is an essential catalytic or structural element of many proteins, and a signaling messenger that is released by neural activity at many central excitatory synapses. Growing evidences suggest that zinc may also be a key mediator and modulator of the neuronal death associated with transient global ischemia and sustained seizures, as well as perhaps other neurological disease stoles. Some neurons have developed mechanisms to accumulate zinc in specific membrane compartment ('vesicular zinc') which can be evidenced using histochemical techniques. Substances giving a bright colour or emitting fluorescence when in contact with divalent metal ions are currently used to detect them inside cells; their use leads to the so called 'direct' methods. The fixation and precipitation of metal ions as insoluble salt precipitates, their maintenance along the histological process and, finally, their demonstration after autometallographic development are essential steps for other methods, the so called 'indirect methods'. This study is a short report on the autometallograhical approaches for zinc detection in the central nervous system (CNS) by means of a modified selenium method.

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Seven Cases of Severe Esophageal Stricture (고도의 식도 협착증 7 예)

  • 김기주;김호성;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.2-5
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    • 1982
  • With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

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Treatment Pattern of Patients with Neuropathic Pain in Korea (한국인 신경병성 동통 환자의 치료 양태 연구)

  • Han, Sung-Hee;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.197-205
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    • 2009
  • The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.

Survey on Preferences Regarding Rubber Dams in Children, Adolescents and Parents (러버댐에 대한 소아, 청소년 및 보호자에 대한 선호도 조사)

  • Jeong, Hankeul;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.17-26
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    • 2016
  • The use of a rubber dam is a useful technique for protecting patients and operators, producing good results when treating children and adolescent patients. Despite its many advantages, some children and adolescent patients have negative feelings and sometimes express its discomfort. The purpose of this study was to evaluate the patients' preferences for rubber dam use and the associated factors that may affect it. A survey was conducted targeting patients aged 4-18 years old who visited the pediatric dental clinic, the restorative dental clinic, or the student treatment dental clinic of ${\bigcirc}{\bigcirc}$ University Dental Hospital, and were treated using a rubber dam without sedation. We collected questionnaires through electronic medical records. Most children and adolescent patients showed positive attitudes towards using rubber dams. The group with a short treatment time and the group with past knowledge or experience of rubber dam use showed more positive attitudes towards rubber dams (p < 0.05), while no significant difference was found among factors such as gender, age, procedure, anesthetics, treatment site, and operator (p > 0.05).

CARIES TREATMENT OF A 4-YEAR-OLD FEMALE PATIENT WITH DE GROUCHY SYNDROME UNDER GENERAL ANESTHESIA : A CASE REPORT (de Grouchy syndrome 환아의 전신마취 하 치아우식 치료 증례 보고)

  • Song, Jisoo;Lee, Euj-Ji;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.1
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    • pp.42-45
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    • 2013
  • De Grouchy syndrome or Distal 18q- is a genetic condition caused by a deletion of genetic material within chromosome 18, and the deletion involves the distal section of 18q. It causes a wide range of medical and developmental concerns. Congenital orthopedic anomalies, cleft lip and palate are relatively common. People with distal 18q- are often small for their age. Most individuals with distal 18q- fall in the mild to moderate range of intellectual disability. Strabismus and nystagmus, changes in the optic nerve as well as colobomas are also fairly common. People with distal 18q- frequently have conductive and/or sensorineural hearing loss. At present, treatment for distal 18q- is only symptomatic. This article presents a case report: Caries treatment of a 4-year-old female patient with de Grouchy syndrome under general anesthesia. The special considerations of dental care, especially caries treatment for the patient with de Grouchy syndrome are discussed.

Tissue reactions to Implanted Intracanal Medicaments in Rats (백서에서 수 종의 근관 내 약제에 대한 조직 반응에 관한 연구)

  • Kim, Mi-Ri;Kim, Byung-Hyun;Kim, Won-Kyung
    • Restorative Dentistry and Endodontics
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    • v.29 no.1
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    • pp.23-29
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    • 2004
  • 최근 근관 치료 영역에서는 적절한 기계적 근관 성형과 근관 세척으로만 효과적으로 근관 내 미생될의 숫자를 감소시킬 수 있어 다른 약제의 사용은 권장되고 있지 않다. 그럼 에도 불구하고 수종의 근관내 약제는 감염된 근관에서 미생물의 숫자를 줄이고 근관 내용물의 불활성화와 삼출액을 줄이기 위해 사용되고 있다. 그 중 포름 알데하이드를 함유하고 있는 Depulpin$^{(R)}$과 근관 치료학에서 오랫동안 널리 사용되어온 수산화 칼슘을 포함하고 있는 Tempcanal$^{(R)}$과 Vitapex$^{(R)}$ 등에 대한 세포 독성은 충분한 연구가 이루어지지 못한 상태이다. 이에 본 연구에서는 이들 약제가 백서에서의 세포 독성에 미치는 영향에 관하여 고찰하고자 하였다. Sprague-Dawley계 백서 숫놈 20마리를 사용하여, 각각의 쥐는 케타민과 럼푼을 근육내 주사하여 마취하였고, 복부의 피하 부위를 절개한 뒤 3개씩의 Teflon-coating된 매식체를 삽입하였다 매식체 안에는 각각 Tempcanal$^{(R)}$, Vitapex$^{(R)}$, Depulpin$^{(R)}$을 넣고, 백서 20마리를 6개군으로 나누어 매식체 삽입 후 1주 뒤, 4주 뒤에 희생시켜 매식체 주위 조직을 잘라내고 10%포르말린에 고정 후 파라핀에 포매 하였다 미세 절단기로 4$\mu$m로 연속 절단 후, hematoxy-line-eosin염색 후 3명의 관찰자가 광학 현미경으로 관찰하여 염증의 정도를 4단계로 평가한 뒤 Kruskall-Wallis test(P<0.05)로 통계 처리하였다. 그 결과 제 1군Tempcanal$^{(R)}$ 7일후 군), 제 2군(Vitapex$^{(R)}$ 7일후 군), 제 3군(Depulpin$^{(R)}$ 7일후 군) 모두 중등도의 염증도를 보였으나, 세 군간의 통계학적 유의성은 없었다. 그러나, 제 4군(Tempcanal$^{(R)}$ 30일후 군)과, 제 5군(Vitapex$^{(R)}$ 30일후 군)의 경우에서는 약한 염증도를 보여주었으나, 제 6군(Depulpin$^{(R)}$ 30일후 군)은 가장 심한 염증 반응과 함께 조직 괴사의 양상을 보여주었으며, 4, 5군과 6군간에 통계학적 유의성을 보였다. 본 실험 결과, Depulpin$^{(R)}$은 Tempcanal$^{(R)}$와 Vitapex$^{(R)}$에 비해 높은 세포 독성을 보여주공 있으나, 좀 더 많은 임상적 검증이 필요할 것으로 사료된다.

Changes in the pathogenicity of Naegleria fowleri by serial brain passage in mice (자유생활아메바 Naegleria fowleri의 계대감염에 의한 병원성의 변화에 관한 연구)

  • 이득기;임경일
    • Parasites, Hosts and Diseases
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    • v.21 no.2
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    • pp.234-240
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    • 1983
  • The pathogenicity of free-living amoeba, Waegleria fcwleri, is influenced according to the strain, cultural condition and host (Culbertson et at., 1968; Carter, 1970; Wong et at., 1975), Phillips (1973) demonstrated that Entamoeba histolytica became avirulent after more than 2 year maintenance in axonic culture in vitro. This study was carried out to compare the difference in pathogenicity between two strains of N. fowleri, one of a prolonged maintenance in arsenic medium and the other one obtained by serial brain passage in mice. The 0 strain was that N. fowleri had cultivated axenically more than 7 years in CGVS medium. The 2-1 strain was obtained from the brain of mouse inoculated intranasally with a strain, which was from the mouse brain infected with 0 strain, and cultured for 15 weeks until the beginning of this experiment. White male mice weighing 18-22 g were used. Mice were anesthetized by an intraperitoneal injection of about 1 mg secobarbital, and inoculated intranasally with $10{\times}$10^4 live N. fowleri trophoBoites in a $5{\;}{\mu}l$ cell suspension. Sluggish behaviour, nervousness, rotation and leg paralysis were developed earlier and more frequently in the 2-1 experimental group than the control 0 group. Pathological changes such as inflammatory and necrotic lesion were observed in the olfactory and anterior portion of brain, and these changes were more extensive in the 2-1 group. The edematous and inflammatory changes in lung were demonstrated in mice died after 13th day post-inoculation. The experimental mice of 2-1 group began to die suddenly from 7th day post-inoculation, and the survival time in 2-1 group mice was shorter than 0 group mice. The typical primary amoebic meningoencephalitis was developed in the mice inoculated intranasally with N. fowleri. The prolonged maintenance of N. fowleri amoebae in axonic CGVS medium was observed to have lost their original pathogenicity for mice, but their pathogenicity was restored by serial brain passage in mice.

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Surgical Treatment of Postinfarct Ventricular Double Rupture - A case report - (심근경색 후 발생한 심실이중파열의 외과 치료)

  • Kim Young Sam;Yoon Young Han;Kim Joung Taek;Kim Kwang Ho;Lim Hyun Kyoung;Kwan Jun;Baek Wan Ki
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.717-720
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    • 2005
  • Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.

Protective Effects of Trimetazidine in a Rabbit Model of Transient Spinal Cord Ischemia (허혈성 척수 손상의 동물실험모델에서 Trimetazidine의 척수 보호효과)

  • 장운하;최주원;김미혜;오태윤;한진수;김종성;이수윤
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.255-260
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    • 2002
  • Paraplegia remains unresolved as the most dreaded operative complication with surgical treatment of descending thoracic and thoracoabdominal aortic diseases. In this study, the neuroprotective effect of trimetazidine that has been used clinically for ischemic heart disease was investigated in a rabbit spinal cord ischemia model. Material and Method: Thirty-three New Zealand white rabbits were randomized as follows: control group undergoing abdominal aortic occlusion but receiving no pharmacologic intervention(Group 1, n= 17); TMZ group(Group 2, n= 16) receiving 3 mg/kg trimetazidine intravenously before the occlusion of the aorta. Ischemia was induced by clamping the abdominal aorta just distal to the left renal artery for 30 minutes. Neurologic status was assessed at 2, 24, and 48 hours after the operation according to the modified Tarlov scale, then the lumbosacral spinal cord was processed for histopathologic examinations 48 hours after the final assessment. Result: The average motor function score was significantly higher in the TMZ group(3.20 $\pm$ 0.77 vs 1.13 $\pm$ 1.25 at 2 hours, 3.50 $\pm$ 0.76 vs 1.45 $\pm$ 1.57 at 24 hours, and 3.91 $\pm$ 0.30 vs 1.86 $\pm$ 1.86 at 48 hours after operation; p value$\leq$0.05). Histologic observations were correlated with the motor scores. Conclusion: The results suggested that trimetazidine reduced spinal cord injury during aortic clamping and that it may have clinical utility for the thoracoabdominal aortic surgery:

Mini-open Rotator Cuff Repair Using Anterolateral Approach - Technical Note - (전외측 도달법을 이용한 소절개 회전근 개 봉합술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Lee, Kyung-Jae;Seo, Hyuk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.49-52
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    • 2010
  • Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

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