• Title/Summary/Keyword: 전신질환자

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STRESS REDUCTION PROTOCOL FOR PROPER EXTRACTION OF ADVANCED INFECTED TEETH IN MEDICALLY COMPROMISED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES (전신질환자에서 과도한 감염치아 발치시 스트레스 감소법 : 문헌적 고찰 및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Hong, Soon-Jae;Nam, Woong;Kim, Jong-Bae;Yoon, Jung-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.1
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    • pp.85-92
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    • 2000
  • Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

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Ictal single-photon emission computed tomography with slow dye injection for determining primary epileptic foci in infantile spasms (영아연축에서 추적자의 느린 점적주사를 이용한 발작기 SPECT)

  • Hur, Yun Jung;Lee, Joon Soo;Kang, Hoon Chul;Park, Hye Jung;Yun, Mi Jin;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.804-810
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    • 2009
  • Purpose : We investigated whether ictal single-photon emission computed tomography (SPECT) with prolonged injection of technetium-99m (99mTc) ethyl cysteinate dimer during repeated spasms can localize the epileptogenic foci in children with infantile spasms. Methods : Fourteen children with infantile spasms (11 boys, 3 girls; mean age, $2.2{\pm}1.3$ years) were examined. When a cluster of spasms was detected during video electroencephalography (EEG) monitoring, $^{99m}Tc$ ethyl cysteinate dimer was slowly and continuously injected for 2 minutes to determine the presence of ictal SPECT. For 7 children, the ictal and interictal SPECT images were visually analyzed, while for the remaining 7 children, the SPECT images were analyzed using the subtraction ictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM) technique. Subsequently, we analyzed the association between the ictal SPECT findings and those of other diagnostic modalities such as EEG, MRI, and positron emission tomography (PET). Results : Increase in cerebral blood flow on ictal SPECT involved the epileptogenic foci in 10 cases6 cases analyzed by visual assessment and 4 analyzed by the SISCOM technique. The ictal SPECT and video-EEG findings showed moderate agreement (Kappa=0.57; 95% confidence interval, 0.18-0.96). Conclusion : Ictal SPECT with prolonged injection of a tracer could provide supplementary information to localize the epileptogenic foci in infantile spasms.

Azoospermia Following Mumps Orchitis:2 Case (볼거리 고환염에 따른 무정자증: 2례)

  • Sim, Hyun-Sun
    • The Journal of the Korea Contents Association
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    • v.16 no.11
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    • pp.767-775
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    • 2016
  • Mumps is an acute viral disease that affects the entire body, including inflammation of the salivary glands. Mumps is accompanied by unilateral or bilateral parotid gland swelling and pain. Mumps virus is spread to others by air, saliva, direct contact, and urine, and occurs in high-density population places such as schools, army, etc. Bilateral testicular involvement is seen in 10-60% of cases. If mumps orchitis affect post-pubertal men, approximately 50% of the infected people are said to experience severe testicular atrophy within 1-2 months as a complication. Mumps orchitis can alter the count, morphology, and motility of sperm and result in oligozoospermia and infertility caused by a rare azoospermia. When suspected of mumps orchitis, active initial symptomatic treatment can prevent infertility due to azoospermia in future adults. A case of mumps orchitis report two cases with references to the ultrasonnography and semen.

PULP REVASCULARIZATION OF IMMATURE FIRST PERMANENT MOLARS WITH APICAL PERIODONTITIS : CASE REPORT (치근단 치주염을 가진 미성숙 제1대구치의 치수 재혈관화 : 증례 보고)

  • Jeon, Hye-Jin;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.192-198
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    • 2012
  • Revascularization of the pulp in a necrotic, infected immature tooth with apical periodontitis was attempting several years. Revascularization of partially necrotic pulp in an immature tooth is based on the concept that vital dental stem cells can survive pulpal necrosis. Revascularization procedure obtains longer and thicker roots in teeth with necrotic pulp diagnosis. Pulp revascularization for immature permanent molars can be possibly applied on cases having difficulty to use conventional root canal treatment due to abnormally thin root canal wall or severe root curvature. Also, when an uncooperative patient does not agree with sedative treatment the revascularization can be useful. And a patient with disability who is barely cooperative can be another indication of this treatment. In this case report, pulp revascularization using triple-antibiotics, metronidazole, ciprofloxacine and minocycline, was applied on the immature first permanent molar infected by caries.

Analysis of considerations in oral health education for elderly diabetic patients: Focus group interview (당뇨병 노인환자의 구강보건교육 시 고려사항 분석: 포커스 그룹 인터뷰)

  • Kim, Ji-Hwa;Lee, Hyekyung;Kang, Kyung-hee
    • Journal of the Korea Convergence Society
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    • v.13 no.5
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    • pp.551-558
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    • 2022
  • The purpose of this study is to identify considerations for oral health and oral health education through group interviews with the general public and those diagnosed with diabetes among the elderly over 65 years of age. The subjects of this study were divided into two groups: 5 healthy people and 5 diabetic patients over 65 who visited the Senior Welfare Center in G city, and each group had a 60-70 minute interview. As a result of the study, four key themes were derived: 'Knowledge on the relationship between diabetes and oral disease', 'Oral health status', 'Oral health management method', and 'Considerations for oral health education'. Healthy people who participated in this study answered that the contents they thought necessary for oral health education were periodontal management method, implant, holistic oral care, and systemic health, and diabetic patients answered that diabetes, periodontal management method, and importance of practicing oral care. Based on the results of this study, it is considered that it is necessary to develop a customized oral health education program for diabetic elderly patients in the future.

The Clinical Examination of Netspeg Lens for Good Visual Acuity (시력 개선을 위한 Netspeg 렌즈의 임상적 검증)

  • Kim, Douk-Hoon;Bae, Han-Young;Kim, Sun-Tae
    • Journal of Korean Ophthalmic Optics Society
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    • v.11 no.3
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    • pp.281-291
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    • 2006
  • The aim of this study was performed the clinical test using Netspeg lens for good visual acuity on subjects with abnormal refraction status. The subjects of one hundreds adults (fifty males, fifty females, mean=21 years, range=19 to 24) were recorded. The subjects were researched the history including the systemic health, medication, genetics, allergy, systemic disease and ocular disease. The refraction test was recorded the monocular and binocular using objective method. Visual acuity was performed the binocular status using the Netspeg lens and CR-39. Stereopsis test was performed the titmus fly and TNO at near distance using Netspeg lens and CR-39. The P-VEP test was used the 16 pattern size(Bausch Lomb, production in USA) with three channels. Also Subjects viewed the p-vep stimulus with binocular vision through the corrected visual acuity using the Netspeg lens and CR-39. The contrast sensitivity test was performed the contrast sensitivity chart(pelli-Robertson, USA) at 1m distance using the Netspeg lens and CR-39. The ultrastructure of surface on the Netspeg lens and CR-39 was observed the SEM(JMS-5800, made in Japan). The results of this study was as follows: 1. In corrected visual acuity of abnormal refraction using the Netspeg lens and CR-39, the Netspeg lens wearer were acquired the good visual field and clear visual acuity comparative to CR-39 wearer in the subject vision test. however the comfort of visual acuity was similar results in the Netspeg lens and CR-39. Also the subjects of Netspeg lens wearer was good visual acuity more than CR-39 wearer and in the analysis of P-VEP, the amplitude of wave on Netspeg lens used appears to be better through the CR-39(p>0.5). Besides, on the contrast sensitivity, the Netspeg lens wearer was good results than CR-39. The value on stereopsis with TNO by Netspeg lens wearer was better than CR-39 in results. However, in the stereopsis test with Titmus, the Netspeg lens and CR-39 wearer was similar results. 2. The ultrastructure of Netspeg lens surface was the smooth and fine shape more than CR-39. Also, Netspeg lens have a fine line structure in ultrastructure. In conclusion, the results of this study conformed that the surface ultrastructure of Netspeg lens used is more specific pin hole design structure than CR-39. This study indicated that the vision of Netspeg lens used have a better than CR-39 in the corrected visual acuity for abnormal refraction eye. Therefore, In this paper, we suggested that the ultrastructure and line structure of Netspeg lens was related to good visual function. However the visual function of the aspheric Netspeg and ultra waterproof Netspeg lens was similar results.

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The Associated Factors with Whole Saliva Flow Rate and Xerostomia (전타액분비율과 구강건조증의 관련요인 분석)

  • Park, Eun-Seon;Choi, Jun-Seon
    • Journal of dental hygiene science
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    • v.12 no.2
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    • pp.171-179
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    • 2012
  • The aim of this study was to analyze the factors related to whole saliva flow and the xerostomia for the ground use of the materials in developing oral health improvement program and life quality improvement program. So, this study performed a questionnaire survey, targeting at 160 adults, older than 40 years, living in Gyeonggi and Incheon provinces from January to February 2011 and measured unstimulated salivary flow rate and stimulated salivary flow rate. The results are as followings. The group of participants who took gums and candies to relieve oral dryness had low stimulated whole saliva flow. The group of participants who graduated from middle schools, who separated by death, who were not healthy with menopause, and who recognized periodontal disease symptoms and tongue burning sensation recognized more symptoms of dry mouth than others. In addition, the group of participants who were not satisfied with life so much, who couldn't feel the meaning of life, and who recognized negative feelings frequently recognized symptoms of dry mouth more. Women, the group of participants who graduated from middle schools, who suffered from depressive symptoms, and who recognized halitosis had low unstimulated whole saliva flow. The group of participants who graduated from middle schools, who were not satisfied with life so much, who couldn't feel the meaning of life, and who were not satisfied with themselves had low stimulated saliva flow.

The Study on Relation between Asthenopia of Lateral Phoria and Fusional Reserve (수평사위의 안정피로와 융합여력과의 관계)

  • Kim, Jung-Hee;Ryu, Kyung-Ho;Kim, In-Suk
    • Journal of Korean Ophthalmic Optics Society
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    • v.11 no.4
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    • pp.329-335
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    • 2006
  • The aim of this study was to evaluate the relation between Asthenopia of near lateral phoria and fusional reserve and also to provide fundamental clinical data. A total of 97 subjects, aged between 17 and 35 years old, who had no strabismus, an eye trouble or whole body disease, were examined nacked visual acuity, corrected visual acuity, corrected diopter, phoria, fusional reserve tests from October of 2005 to July of 2006. We excluded 8 subjects for the following reasons: if they had an amblyopia affecting binocular vision or inaccurate data. After these exclusions, 87 subjects remained. The results were as follow. According to interview results was that in near works, exophoria and esophoria with asthenopia was 59.6%, 64.7%, and 52.6% respectively. The subjects who have exophoria of $0-6{\Delta}$ in the range of normal state was 19.1%. The subjects who have exophoria of $7{\Delta}$ over in the range of abnormal state was 80.9%. The fusional reserve was in inverse proportion to phoria. The fusional reserve was twice over of phoria were 30.3%, and twice under were 69.7%. The asthenopia complain persons were 33.9% with the twice over fusional reserve of phoria. The asthenopia no complain persons were 66.1% with the twice under fusional reserve of phoria. In conclusion, our research has shown conclusively that there is a link between asthenopia of lateral phoria and fusional reserve and we also find that fusional reserve must be examined when we prescribe for a patient who has phoria.

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Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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Advance Understanding and New Treatment of Alopecia Areata (원형탈모증(alopecia areata)의 최신 이해와 치료)

  • Kang, Kyung-Hwa
    • Journal of Life Science
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    • v.26 no.11
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    • pp.1345-1354
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    • 2016
  • Alopecia areata (AA) is a common and tissue-specific autoimmune disease of hair follicle resulting in the loss of hair on the scalp and elsewhere on the body. Hair follicles is a unique organ because it has its own immune system and hormonal milieu and has a different immune state at each hair cycle stage. The collapses of anagen-dependent hair follicle immune privilege arise autoimmune attack, inducing ectopic MHC class I expression in the hair follicle epithelium and autoantigen presentation to autoreactive CD8+T cells, which results in AA. Clinical and experimental studies have pointed that psychological stress may also influence the hair follicle immune/hormone systems and contribute to the induction of AA. The key pathogenesis of AA is associated with immune privilege guardians (including ACTH, ${\alpha}-MSH$, and $TGF-{\beta}$), natural killer group 2D-positive (NKG2D+) cells (including NK and CD8+T cells), and stress hormones (including CRH and substance P). Effective treatments for AA are still demanded. One of the future targets of treatment will be the modification of hair follicle immune privilege including stress. Recent studies have reported that JAK inhibitors and immunomodulators used in other autoimmune disease, such as psoriasis, atopic dermatitis, and rheumatoid arthritis, Tregs, platelet-rich plasma therapy, statins, and prostaglandin anaolgues are effective for AA. Here the article reviews the recent understanding in the pathogenesis associated with perifollicular endocrine/immunology and new treatments of AA.