• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.1-5
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• 2016

Robinow syndrome is skeletal dysplasia with both autosomal dominant and recessive inheritance patterns. It is characterized by short-limbed dwarfism, abnormalities in the head and face, as well as vertebral segmentation. A 2-year-7-month old boy with Robinow syndrome had visited Seoul National University Dental Hospital, for the evaluation of tooth palatal eruption on maxilla. He had micrognathia, delayed tooth eruption, cleft lip with bifid uvula. He also had an erupted mesiodens on the palatal side of maxillary primary incisors, which was tuberculated and 8mm in major diameter. The patient was scheduled for mesiodens extraction under general anesthesia. He was a young child with delayed development, so general anesthesia was inevitable. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. There were no postoperative complications related to anesthesia and dental treatment. Robinow syndrome patients have craniofacial dysmorphism and eruption disorders. Therefore, he requires regular check-ups as well as dental managements.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.9-16
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• 2009

Background: This study aimed to evaluate the cooperative levels of dental patients requiring general anesthesia during dental treatments. Anesthetic induction methods for patients were also recorded and analyzed using descriptive statistics. Methods: Total 566 patients who visited Seoul National University Dental Hospital Clinic for Persons with Disabilities were reviewed on pre-anesthetic review and anesthesia records. The cooperative levels of patients were graded by 4 levels and induction methods used for the patients during general anesthesia application were analyzed. Results: More than half of patients(55.8%) were willing to receive the anesthetic induction(cooperative level 1), 18.6% were minimally cooperative(level 2), 20.8% needed physical restraint prior to induction(level 3), and 4.8% was poorly cooperative and induction procedure was performed under an unconscious condition after ketamine intramuscular injection(level 4). There was no gender difference in cooperative levels(P=0.11). Patients over 30 years revealed better cooperation levels compared to other age groups(P<0.05). For patients of level 1, 53.5% were anesthetized in a way of intravenous induction, while 77.1% out of patients of level 3 were anesthetically induced through inhalation method. Conclusion: Many dental patients with special needs were not cooperative to receive anesthetic induction. Additional behavioral support may be applied to poorly cooperative patients for the safe and successful clinical outcome.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.104-107
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• 2017

Kabuki syndrome is characterized by typical facial features (elongated palpebral fissures with eversion of the lateral third of the lower eyelid; arched and broad eyebrows; short columella with depressed nasal tip; large, prominent, or cupped ears), minor skeletal anomalies, persistence of fetal fingertip pads, mild to moderate intellectual disability, and postnatal growth deficiency. A 6-year-old male with kabuki syndrome was referred from the local dental clinic for left facial swelling and dental caries on all primary molars. He was treated for acute periapical abscess with incision and drainage under physical restraint, and left maxillary second primary molar was extracted. Other caries treatment was performed under general anesthesia. As the syndrome involves many different medical problems, special cares should be considered. Dental treatment should be carried out in comprehensive consultation system.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.4
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• pp.379-386
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• 2015

Purpose: The trend of body temperature change during laparoscopic surgery and the most adequate site for monitoring temperature measurements have not been investigated thoroughly. In this study body temperature change during laparoscopic surgery was measured and measurements of the tympanic, esophageal, and nasopharyngeal core temperatures in surgical patients with total intravenous anesthesia were compared. Methods: From February to October 2013, 28 laparoscopic surgical patients were recruited from a tertiary hospital in Seoul. The patients' core temperature was measured 12 times at ten minute intervals from ten minutes after the beginning of endotracheal intubation. Results: Repeated measure of core temperatures indicated a significant difference according to body part (p=.033), time of measure (p<.001) and the reciprocal interaction between body part and time of measure (p<.027). The core temperatures were highest at tympany location, lowest at nasopharynx. The amount of temperature change was least for the esophagus ($36.10{\sim}36.33^{\circ}C$), followed by nasopharynx and tympany. Conclusion: The esophageal core temperature showed the highest stability followed by nasopharyngeal and tympanic temperature. Therefore, close observations are required between 10~20minutes after the beginning of the operation.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.47-51
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• 2017

Haddad syndrome, the association of Congenital Central Hypoventilation Syndrome (CCHS) and Hirschsprung's disease (HD), is a disease caused by mutation of PHOX2B gene. This disease, which occurs very rarely worldwide, is characterized by adequate ventilation during wakefulness and hypoventilation during sleep due to decreased ventilatory sensitivity. In this case report, we report a case of dental treatment under general anesthesia in a child with Haddad syndrome. A 3-year-old child with Haddad syndrome visited Seoul National University Dental Hospital for dental treatment. Dental treatment was planned under general anesthesia because of his medical condition. Treatment was successfully done without any postoperative complications. This case suggests that general anesthesia may be advantageous for dental treatment due to the risk of respiratory depression in a child with Haddad syndrome.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.1
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• pp.31-35
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• 2018

Dentinogenesis imperfecta is a hereditary disorder that causes abnormal dentin formation and tooth morphology. Affected teeth show very thin dentin and large pulp chamber. Immediately after their eruption, the teeth tend to be destroyed rapidly. Early dental intervention is recommended to improve the feeding capacity and quality of life for the child, to maintain vertical dimension, and to promote healthy and functional dentition. This case report describes a treatment for a 4-year-2-month-old girl whose primary and permanent dentition were affected by Dentinogenesis Imperfecta. Shell teeth were observed in the entire primary dentition. The pulp of most teeth was exposed and the patient complained of pain. Most paternal family members were transferred to the Dentinogenesis Imperfecta. She needed an extensive dental treatment, but her compliance could not be expected because she was very young and anxious. So we decided to treat her under general anesthesia. All molar teeth are restored with Stainless Steel crown. Maxillary anterior teeth were extracted and mandibular anterior teeth are restored with composite resin. The patient's pain disappeared and masticatory function was restored.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.68-74
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• 2011

Rett syndrome is a X-linked genetic neurological disorder characterized by developmental regression, particularly in relation to expressive language and use of the hands, together with profound mental retardation, that almost exclusively affects females. Oral manifestations of the disease are commonly associated with the clinical conditions such as convulsion activity, difficulties for oral hygiene behavior, walking problems and oral/digitalmanual habits. Bruxism is the most frequently observed oral habit in patients with Rett syndrome. Two cases with the Rett syndrome were reported. Both patients had the typical manifestations like stereotypic hand movement, bruxism and digit-hand sucking. Caries control for the patients was perfomed under general anesthesia.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.161-165
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• 2012

Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney, brain and musculoskeletal system, and occurs predominantly in males. The patient with Lowe syndrome is characterized with congenital cataracts, glaucoma, prominent forehead, thin and sparse hair, mental and growth retardation, muscular hypotonia, renal dysfunction, and metabolic bone disease. We have experienced a 10-year-old boy with Lowe syndrome who had poor oral hygiene and trouble for teeth brushing. To manage his behavior and systemic metabolic disorder, sedation was performed during dental care. Excessive calculus formation in this patient is caused by both medication and lack of ability to maintain oral hygiene. The dental management of those patients has to be focused on prevention due to difficulties in dental treatment and dangers of general anesthesia for the Lowe syndrome.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.2
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• pp.102-105
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• 2018

Hemophilia is an X-linked herediatry disorder. Hemophilia A is a defiency of factor VIII and hemophilia B (Christmas disease) is a deficiency of factor IX. The most widely used classification is based on plasma procoagulant levels, with people <1% factor defined as severe; 1 - 5% moderately severe; and >5% as mild. A 7 years old boy visited our clinic with chief complaint of impacted supernumerary tooth. This boy had severe hemophilia A. With the previous $ADVATE^{(R)}$ injection and factor VIII replacement, Extraction of supernumerary tooth was successfully done under General anesthesia. A 9 years old boy referred from local clinic for dental caries treatment. This boy had severe hemophilia B. With the preparation of $BeneFIX^{(R)}$ injection, dental treatment was done successfully under general anesthesia. It is often first detected by dental trauma. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. The treatment of the patients with either hemophilia A or hemophilia B involves the intravenous infusion to either control or prevent bleeding.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.250-258
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• 1993

Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.