• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.575-579
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• 2009

Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.344-350
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• 2007

Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack- Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.

• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.301-304
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• 2013

Otic mass removal was performed in a 19-month-old, castrated domestic shorthair cat. The patient had 1- year history of recurrent otitis externa, and then otic mass in the right ear canal was found. Under general anesthesia, 2.7 mm rigid endoscope was inserted to the right ear canal with the irrigation system. The ovoid-shaped, 4.9 mm in diameter red otic mass located in the right ear canal was removed via traction-avulsion. Then, rupture of the tympanic membrane was revealed and otic flushing was performed with sterile isotonic (0.9%) saline to remove exudates. Histologically, the removed polyp was diagnosed as granulation tissue with severe ulceration. The patient didn't reveal any remarkable abnormality after surgery, and no recurrence were found after 5 months follow up. The video otoscopy seems to offer a useful option for treatment of a feline inflammatory polyp.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.118-126
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• 2002

배경: 체외순환에 의해 생성되는 염증매개체는 소아 환자에서 술 후 다기관 기능부전과 연관이 있다. 본 연구에서는 선천성 신장질환 소아환자에서 체외순환에 의한 전염증성 사이토카인과 케모카인의 유전자 발현 특성에 대해 알아보고자 하였다. 대상 및 방법: 개심술을 시행한 18명의 소아 환자의 요골 동맥에서 마취유도 후(기준치), 체외순환(0시간), 체외순환 2시간 후 24시간 후, 48시간 후에 혈액을 채취하였다. 모든 환자에서 인터루킨-1알파, 인터루킨-1베타 인터루킨-6, 인터루킨-8, 종양괴사자인자-알파, 인터루킨-15,인터페론 감마의 mRNA의 유전자 발현 정도를 반정량적으로 역전사 중합효소 연쇄반응으로 측정하였다. 6명의 환자에서 인터루킨-6단백치는효소결합면역흡착검사로 측정하였다. 결과: 전신적인 인터루킨-6 mRNA와 비슷한 양상을 보였으나 최고치는 인터루킨-6보다 낮은 값을 보였다. 인터루킨-1알파와 인터루킨-1베타의 mRNA의 발현은 체외순환 2시간 후에 최고치를 나타내었고 체외순환 2시간 후에 최고치를 나타내었고 체외순환 48시간 후에 감소하였다. 종양괴사자인자-알파는 체외 순환 24시간 후에 최고치를 나타내었고 체외순환 48시간 후에 감소하였다. 인터루킨-15 mRNA 발현은 체외순환 전후와 비교하여 유의한 변화가 없었다. 인터페론-감마는 시간이 지남에 따라 감소하였다. 결론: 선천성 심장질환으로 개심술을 시행한 소아환자의 혈청 내 인터루킨-6, 인터루킨-8, 인터루킨-1알파, 인터루킨-베타, 종양괴사자인자-알파의 유전자 발현은 체외 순환 전후로 유의한 변화를 보였다. 인터루킨-15는 유의한 변화가 없었고 인터페론-감마는 반대 양상의 변화를 보였다. 체외순환 후 전염증성 사이토카인과 케모카인의 높은 혈중 농도는 술 후 조직 손상과 연관되리라 생각한다.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.148-152
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• 2013

We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.2
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• pp.467-475
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• 1998

악안면 영역에 동통이 가하여지면 회피반사의 일종인 개구반사가 유발되며, 개구반사의 크기는 뇌간의 중추에 전달된 동통의 크기에 비례한다. 따라서 동통의 정도를 악이복근의 근전도를 이용하여 정량화 할 수 있고 동통의 지표로 이용할 수 있다. 본 실험은 악안면동통에 의하여 유발된 개구반사의 크기가 침점(족삼리) 전기자극으로 감소되는지와 이러한 전기침의 효과가 나타나는데 opioid 물질이 관여하는지에 대하여 연구하고자 하였다. 8주 이상, 150g이상의 Sprague-Dawley계 쥐 34 마리를 암수 구별없이 이용하여 실험하였다. 복강 내 Urethane용액(1.5g/kg)을 주입 전신마취하고 악이복근을 노출시켜 근전도 기록을 위한 한쌍의 선전극을 삽입하였다. 동통유발을 위하여 구강내 하악 이공주변에 0.1mm의 선전극을 한쌍 삽입하고 전기자극기에 연결하였다. 유해자극 조건은 duration $100{\mu}sec$, interval 5sec의 pulse로 정하고 자극의 크기는 개구반사를 일으키는 역치의 2배 크기로 하며 매 측정시마다 동일 자극을 10회식 가하여 평균하였다. 침점의 전기자극을 위하여 침점의 하나인 족삼리(Zusanli)에 표면전극(넓이 $0.4cm^2$ 정도)을 부착하고 자극부위가 약한 근수축을 일으키는 강도인 $100{\mu}sec$, 5V, 2Hz의 자극을 20분간 가하였다. 악이복근의 근전도는 교류증폭기 (Dam80, WPI, USA) 에서 1000배 증폭하여 유해자극이 가해진 순간 oscilloscope 에서 관찰하여 그 크기를 측정하였다. 침점의 전기자극으로 나타나는 진통효과가 opioid의 분비와 관련있는지 알아보기 위하여 opioid 의 길항제인 naloxone(0.2mg/kg)을 복강 내로 투여하였다. 실험군을 4군(group I - IV)으로 분류하였고 각 군에서 근전도를 측정한 단계는 다음과 같다. group I : control 침점에 전기자극 20 분간 가한후(EA), 20분후(EA20) group II : control 침점에 전기자극 20분간 가한후(EA), naloxone 투여 20분후(NX) group III : control naloxone 투여 5분후 침점에 전기자극 20분 가한후(NxEA20) group IV : control naloxone 투여 20분후(NX20) 구강내에 가해진 유해자극에 의하여 발생하는 악이복근 근전도는 족삼리 침점의 전기자극으로 그 크기가 감소하였고 이러한 침점자극의 효과는 naloxone의 투여로 인하여 억제되었다. 이와 같은 결과는 침점자극으로 진통작용이 나타나는데에 opioid 물질이 관여하고 있음을 시사한다.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.374-380
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• 2010

Treacher Collins syndrome(TCS) is a rare, incurable condition occurring in approximately 1 of 25,000 to 50,000 births. It may occur as a spontaneous mutation out of genetically normal parents or it may be manifested as an autosomal dominant pattern. TCS is characterized by facial deformities such as, underdevelopment of the maxilla, mandible and zygoma, malocclusion, bilateral deformities of auricles, antimongoloid slant of the palpebral fissures. The syndrome is often associated with cleft lip and palate, ear malformations and hearing loss, short stature, and anomalies of the heart and skeleton. Respiratory difficulty associated with air way obstruction may also be observed, and there is considerable difficulty in airway management during general anesthesia. It is necessary that dentists provide safe dental treatments and guidelines to TCS patients by providing adequate understanding about the characteristics of the syndrome and proper ways of managements. The purpose of this study is to report the dental and medical characteristics of the patient who visited the Department of Pediatric Dentistry, Yonsei University for multiple dental caries treatment and to review the literatures of TCS.

• The Korean Journal of Pharmacology
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• v.29 no.1
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• pp.33-41
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• 1993

Central analgesic effect of capsaicin was assessed by the tail flick reflex (TFR) test, using male Sprague-Dawley rats under anesthesia with pentobarbital sodium (induction with 40 mg/kg and maintenance with $4{\sim}8\;mg/kg/hr$). Level of norepinephrine in the spinal cord was also measured. Capsaicin, $35{\sim}150\;{\mu}g$, was injected intrathecally, and the TFR latency was measured before, 10, 30, and 60 minutes after the drug administration. TFR latency was increased 100% or more immediately by intrathecal capsaicin, from 2.9 seconds to the maximum of 7.0 seconds at 10 minute after the drug; P<0.01. The increase in TFR latency was maintained during the course of experiment of 2 hours. Concomitant reduction of NE content in the spinal cord was observed; from 16 ng/mg protein to 7 ng/mg protein. On the other hand, subcutaneous injection of capsaicin of 50 mg/kg did not change the TFR latency although the NE content reduced similarly to the case of intrathecal injection. Pretreatment of the animal with 0.5 mg/kg of MK-801 reversed the increase of TFR latency and NE reduction induced by intrathecal capsaicin. These results suggest that capsaicin causes analgesia at the spinal cord level by activating the excitatory amino acid-NE-dorsal horn interneurons axis of the descending inhibitory pain modulation pathway.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.1
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• pp.12-17
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• 2009

Background : To do dental treatments successfully for dentally disabled patients who are unable to cooperate to procedures needs deep sedation (DS) or general anesthesia (GA). But there are some difficulties in selecting DS because of some disadvantages such as airway problem etc. But, if we select appropriate cases, DS would be better than GA. Methods : We reviewed total 238 cases of patients who had received dental treatments under GA or DS at the clinic for the disabled in Seoul National University Dental Hospital from November 2007 to February 2009. To compare anesthesia condition between DS and GA, we reviewed preanesthesia evaluation sheet, anesthesia or sedation records and PACU sheets retrospectively. Results : The number of DS cases was 25 (11%) and that of GA was 218 (89%). To maintain DS, intravenous propofol was infused with syringe pump (100%), and sevoflurane (134 cases) or propofol (13 cases) were used for sedation induction. Mean total treatment time for DS was 36 min and 2 hour 25 min for GA. The recovery time at PACU was 44 min for DS and 80 min for GA. There were no severe complications in DS, but 18 cases showed nausea and vomiting in GA. Conclusion : Deep sedation for disabled dental patients should be selected for effective behavioral control in conjunction with general anesthesia, considering duration and pain-evoking potentials of dental treatment and type and severity of patients' disabilities altogether.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.76-76
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• 1993

Endotracheal intubation is common technique for general anesthesia or patency of airway. However, laryngeal intubation granuloma is the most common sequale of endotracheal intubation in otolaryngologic field. From 1982 to 1992, the authors had experienced 16 cases intubation granuloma. The following results were as follows; 1. Age distribution was mostly in the 20 to 49 years old group (84 %).The sex ratio of male to female was 1:7, predominantly in female. 2. Main sx. were hoarse in 12(75%), F.B. sensation in 3(18%), dyspnea in 1 (6%). 3. The side of lesion was bilateral in 6 cases (37%) and unilateral in 10 cases (63%). Unilateral had the 3 cases (30%) in left and the 7 cases (70%) in right. The location of mass was vocal process of arytenoid cartilage in 8 cases(50%), post 1/3 of vocal cord in 6 cases (37 %) and middle 1/3 of vocal cord in 2 cases (12 %). 4. The duration between extubation and onset of symptom in less than a month was most frequent in 7 cases (44 %) out of 16 cases. 5. The most common operation was cesarean section in 6 cases (37 %). 6. Mean duration of intubation time was 2 hour 5 minutes. 7. Composition of used intubation tube was red rubber tube. 8. One case (6 %) was recurred.