• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.3
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• pp.513-519
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• 1999

Chloral hydrate is one of the most widely used sedative agents to control the difficult to treat young age group in the dental clinic. We are often frustrated to see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried sleep induction with Enflurane (1-1.5vol%) for 60 seconds to 37 patients of those who failed to respond properly to the dose(70mg/kg)of oral Chloral hydrate. The average age and weight of the patients was 34.3 months(22-43mo.) and 14.9kg(11-21kg) respectively. It is suggested that sleep induction with low dose Eflurane produced a stable state during dental treatment with respect to vital sign and behavior. Evidence of adverse effect was not detected or reported during and/or after the procedures.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.17-21
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• 2018

Williams syndrome (WS) is a rare congenital disorder which is caused by microdeletion of approximately 1.6 MBP from the long arm of chromosome 7 at 7q11.23. It is characterized by cardiovascular anomalies, elfin face and mental retardation. The most typical oral signs in patient with WS are hypodontia, reduced mesio-distal dimensions both in the primary and permanent teeth, macroglossia, excessive interdental spacing, enamel hypoplasia and enamel hypomineralization. The majority of children with WS have mild to moderate mental retardation, generalized anxiety disorder, hyperactivity disorder and sensitivity to sounds. The purpose of this presentation is to describe dental treatment for a child with WS. A 9-year-old boy diagnosed with WS had caries on his first permanent molars. Because of the poor cooperation, these teeth were filled temporarily with glass ionomer, and treatment under general anesthesia was planned. Under general anesthesia, caries treatment of first permanent molar and extraction of primary molar was successfully performed and there was no postoperative complications related to general anesthesia. Open bite, hypodontia, excessive dental space, enamel hypoplasia, enamel hypomineralization were observed which were characteristic in WS.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.36-40
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• 2018

CATCH22 syndrome or DiGeorge syndrome is a medical acronym of cardiac defects, abnormal facial appearances, thymic hypoplasia, cleft palate, and hypocalcemia. Patients with CATCH22 syndrome are susceptible to infection due to an absent or hypoplastic thymus and often have difficulties in maintaining good oral hygiene, which may require dental treatment. We present a case of dental treatment for the uncooperative child with CATCH22 syndrome under general anesthesia. A 4-year-old, 14.8 kg boy with CATCH22 syndrome visited Seoul National University Dental Hospital for dental check up. The patient had multiple caries requiring dental treatment. He experienced the corrective heart surgery due to Tetralogy of Fallot a few years ago. General anesthesia was planned because his heart rate and vital sign had shown unstable during the previous conscious sedation procedure. Dental restorative treatments were successfully performed and no complications were observed during and after the procedure. Safe and effective dental management of the patients with CATCH22 syndrome could be performed with the help of general anesthesia and careful monitoring.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.38 no.9
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• pp.739-745
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• 2014

Although medication is given to heart disease patients, conventional medication alone is not sufficient to treat heart disease. However, it has been reported that left ventricular assist device (LVAD) transplantation is an effective bridge to heart transplantation by assisting cardiac function. This study used long-term animal testing and emergency situations with a bovine model (Holstein) and canine model (Labrador-retriever) to evaluate the biocompatibility of LibraHeart-I (LH-1), which is a bent-tube type of LVAD that was developed in a previous study. In the long-term animal testing with the bovine model, the subjects survived for 49 days with no irregularities observed in their complete blood cell counts or the vital sign tests that were carried out during the test period. In short-term animal testing with the canine model, it was observed that blood did not remain inside the LH-I even without power support from an external drive source. In this study, the biocompatibility of the LH-I that was developed in a previous study was verified by the ejection performance during long-term animal testing and emergency situations.

• Child Health Nursing Research
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• v.19 no.2
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• pp.111-119
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• 2013

Purpose: This research was a descriptive study of nursing activities observed in nursing simulation during a senior nursing student practicum. Content and frequencies of nursing activities during the simulation practice were identified. Methods: Thirty-six episodes of pediatric nursing simulation were videotaped. Both verbalizations and descriptions of nonverbal behaviors were recorded from the videotapes. The data were coded and analyzed. The coded nursing activities were evaluated for frequency and purpose of interaction. Results: Average time per simulation episodes was 27 minutes and ranged from 3.30 to 32.54 minutes. Nursing activities in these simulation episodes included nursing assessments such as vital sign measurement, associated symptom assessment, and check of patient condition, nursing interventions such as medication, tepid water massage, fluid therapy, provision of oxygen, suctioning, hyperglycemia and hypoglycemia management, communication such as parent education, procedure guidance, and communication among providers. Activities in assessment were most frequent, and among them, vital sign measurement and check of patient condition were more frequent than others. Conclusion: Students showed enhanced nursing activities such as more frequent nursing assessment, communication and interventions in their simulation experience. Therefore simulation experience can be considered as one strategies to provide nursing students with better and more intense practicum experience.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.643-652
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• 2006

The purpose of this study was to elucidate the size and morphologic characteristics of maxillary primary first molars in Korean children using three-dimensional laser scanner and compare three-dimensional image with preformed stainless steel crown. Scanned three-dimensional images of dental cast taken from 132 children(male 62, female 70) by three-dimensional laser scanner(Breuckmann opto-Top HE100, INUS, Korea) were used. Mesiodistal diameter, buccolingual diameter, occlusogingival height and crown shape of each image were calculated by Rapidform 2004 program(INUS, Korea). The values were statistically compared by independent samples t-test with 95% of significant level. The results were as follows : 1. No significant difference in crown size was found between left and right maxillay primary first molar(p>0.05). 2, Significant difference in mesiodistal diameter, buccolingual diameter, buccal occlusogingival height was found between male and female (p<0.05), and crown size of male was bigger than that of female. 3. Average image of maxillay primary first molar was shaped three-dimensionally and measured. In comparison with 3M stainless steel crown, this image was similar with No.4 or No.5 SS crown in male, No.4 in female. In comparison with ILSUNG SS crown, this image was similar with No.5 in male, No.4 in female. 4 Mesiolingual line angle area, distolingual line angle area and buccogingival ridge were more obvious in average image than 3M stainless steel crown. ILSUNG SS crown was more square and had longer mesiodistal diameter than average 3D image.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.427-436
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• 2008

Purpose. The objective of this study was to evaluate the behavioral response and assess the effectiveness of additional intranasal (IN) and submucosal (SM) administration of midazolam during pediatric sedation for dental procedure. Material and methods. Thirty-three cases of healthy (ASAⅠ), uncooperative children aged from 24 to 72 month old at pediatric dental clinic of Ewha Womans University Hospital were selected for this study. Children received oral chloral hydrate 50 mg/kg with hydroxyzine 1.0 mg/kg. After waiting for 45 minutes, midazolam 0.2 mg/kg was administrated via IN route and via SM route randomly maintaining 50% of $N_2O$. A pulse oximeter and a capnograph were used for measuring vital signs ($SpO_2$, PR, RR, $EtCO_2$) throughout the sedation. Behavioral response was evaluated as Quiet (Q), Crying (C), Movement (M) or Struggling (S) in every 2 minutes for 40 minutes. Results. There were also no statistically significant differences in vital signs of the two groups. The behavioral response for the first ten minutes during sedation was a statistically significant difference (P < 0.05) between the two groups. After the first ten minutes, it was revealed that there was no significant difference. Conclusion. This study demonstrated that the addition of IN midazolam to the combination of oral chloral hydrate with hydroxyzine and nitrous oxide/oxygen inhalation is as safe and effective as that of SM midazolam in pediatric sedation for dental procedure.

• Proceedings of the KSR Conference
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• 2007.11a
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• pp.517-528
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• 2007

Domestic or international existing researches regarding rail damage factors are focused on laying, vehicle conditions, driving speed and driving habits and overlook characteristics of track structure (elasticity, maintenance etc). Also in ballast track, as there is no special lateral spring stiffness of track also called as ballast lateral resistance in concrete track, generally, existing study shows concrete track has 2 time shorter life cycle for rail replacement than ballast track due to abrasion. As a result of domestic concrete track design and operation performance review, concrete track elasticity is lower than track elasticity of ballast track resulting higher damage on rail and tracks. Generally, concrete track has advantage in track elasticity adjustment than ballast track and in case of Europe, in concrete track design, it is recommended to have same or higher performance range of vertical elastic stiffness of ballast track but domestically or internationally review on lateral spring stiffness of track is very minimal. Therefore, through analysis of service line track on site measurement and analysis on performance of maintenance, in this research, dynamic characteristic behaviors of commonly used ballast and concrete track are studied to infer elasticity of service line track and experimentally prove effects of track lateral spring stiffness that influence curved rail damage as well as correlation between track elasticity by track system and rail damage to propose importance of appropriate elastic stiffness level for concrete and ballast track.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.1
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• pp.66-71
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• 2013

Muscular dystrophy is a genetically heterogeneous group of disorders characterized by progressive muscle weakness of variable distribution and severity. Fukuyama type congenital muscular dystrophy (FCMD) is an unusual form of muscular dystrophy with autosomal recessive inheritance and is clinically characterized by an early age of onset, severe central nervous system involvement, facial muscle weakness, and multiple joint contractures. Muscular dystrophy is susceptible to perioperative respiratory, cardiac and other complications. Patients with FCMD have upper airway muscle weakness, therefore general anesthesia is preferred to sedation regarding maintaining the airway when treating these patients. The development of malignant hyperthermia in general anesthesia for patients with muscular dystrophy is a concern. Total intravenous anesthesia should be used instead of inhaled anesthetics because of the risk of malignant hyperthermia. A 3-year-9-month old, 13kg girl with Fukuyama type congenital muscular dystrophy was scheduled for dental treatment under general anesthesia. She had multiple caries and 14 primary teeth needed caries treatment. Prior to general anesthesia, oral premedication with 9 mg midazolam was given. General anesthesia was induced and maintained with target controlled infusion of propofol $3{\sim}3.5{\mu}g/mL$. The patient with progressive muscular dystrophy was successfully treated under total intravenous anesthesia with a target controlled infusion of propofol. There were no complications related to anesthesia and dental treatment during or after the operation. This case suggests that target controlled infusion of propofol is a safe and appropriate anesthetic technique in FCMD patients for dental treatment.