• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.447-451
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• 2001

With the exception of gun shot wound, the incidence of penetrating injury of face and neck areas nonorganic foreign bodies is relative low. But the diagnostic evaluation and therapeutic management of penetrating facial wounds need careful decision, when the anatomic proximity of the major vessels and nerve is considered. Penetrating facial trauma with concomitant vascular injury present challenging problems, the immediate complication of this vascular injury are severe bleeding, hematoma formation, shock, obstruction of airway. The vascular injury is conformed by angiography. In this report, a industrial tool(long tack) fired by explosive air is penetrated into face and to neck. In angiograms penetrating injury of the vertebral artery is detected. We performed the embolization of the vertebral artery with coils and manual removal of the foreign body without any complication was followed.

• 한국학교보건학회지
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• 제23권2호
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• pp.133-142
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• 2010

Purpose: The purpose of this study was to identify awareness, attitude and perceived competence about cardiopulmonary resuscitation in elementary school students. Methods: Data were collected from a convenience sample of 616 5th and 6th grade elementary school students in Korea during September and December 2008. A self-questionnaire was used to gather the data. Descriptive statistics, t-test, $x^2$ test, Pearson correlation coefficients and multiple stepwise regression with the SPSS program were used to analyze the data. Results: Among the items related to elementary school students' awareness of cardiopulmonary resuscitation, artificial respiration was perceived at the highest rate (91.9%) and was followed by cardiopulmonary resuscitation, chest compression and airway management. The mean score for attitude 3.51, perceived competence 3.47. There was a positive correlation between awareness, attitude and perceived competence. Attitude and awareness were significant predictors and explained 57.5% of perceived competence about cardiopulmonary resuscitation. Conclusion: The results indicate the necessity of developing effective cardiopulmonary resuscitation education programs for elementary school students.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.490-496
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• 2000

We have conducted a retrospective study of 224 patients with the diagnosis of oral and maxillofacial infection who had been treated between 1988 and 1999 at Gyeong-Sang National University Hospital. This study was aimed to furnish the data of oral and maxillofacial infection and to aid diagnosis and treatment. The most common fascial space involved, as determined by clinical, radiologic, and operative findings, were the submandibular space(39.4%). The most frequent cause of oral and maxillofacial infection was odontogenic 68.8%. In the odontogenic cause, dental caries was the most common cause. Two-hundred three patients required surgical drainage of the abscess. Seventeen patients needed tracheostomy for airway control. The overall mortality was 0.9% despite aggressive anti-microbial therapy and early surgical intervention. All other patients had an uneventful recovery without major complication except osteomyelitis case(6.0%). The combination of early radiologic diagnosis, effective antimicrobial therapy, and intensive surgical management contributed to the good prognosis.

• 대한치과마취과학회지
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• 제7권1호
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• pp.18-21
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• 2007

Pelizaeus-Merzbacher disease (PMD) can be defined as an X-linked recessive leukodystrophy that is caused by a mutation in the proteolipid protein gene on chromosome Xq22. PMD is one of a group of progressive, degenerative disorders of the cerebral white matter known as the leukodystrophies. Due to the progressive nature of the disorders and their devastating effects on the central nervous system, these children frequently require anesthesia during imaging procedures such as MRI or during various surgical procedures. Anesthetic concerns in theses cases include high prevalence of seizure disorders, gastroesophageal reflux with the risk of aspiration, airway complications related to poor pharyngeal muscle control and copious oral secretions, and mental retardation. We report a successful anesthetic management in a patient with PMD for dental procedures.

• 대한치과마취과학회지
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• 제10권1호
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• pp.27-33
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• 2010

The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.423-425
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• 2013

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.

• 대한구순구개열학회지
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• 제11권1호
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• pp.13-22
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• 2008

Velopharyngeal insufficiency(VPI), characterized by hypernasal resonance and nasal air emission, is a speech disorder that can significantly compromise speech intelligibility. Cleft palate, previously repaired cleft palate and submucous cleft palate are associated with VPI. Less commonly, patients may acquire it after adenoidectomy with or without tonsillectomy or as a result of neuromuscular dysfunction. Comprehensive evaluation by a VPI team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, MRI and instrumental assessment. Options for intervention include speech therapy, intraoral prosthetic devices and surgery. Surgical methods can be categorized as palatal, palatopharyngeal or pharyngeal procedures. Each surgical approach has its strengths and limitations. Oro-maxillofacial surgeons are increasingly involved in the referral, evaluation, and treatment of velopharyngeal function. Therefore, understanding of physiology, anatomic structures, evaluation and treatment protocols in VPI is very important. This article presents protocol for evaluation of velopharyngeal function with a focus on indications for surgical interventions.

• 대한치과마취과학회지
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• 제6권2호
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• pp.121-126
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• 2006

Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction. Most fatalities from anaphylaxis occur within the first 30 minutes postantigenic exposure. The mechanism of generalized anaphylaxis is the reaction of IgE antibodies to an allergen that causes the release of histamine, bradykinin, and others. These chemical mediators cause the contraction of smooth muscles of the respiratory and intestinal tracts, as well as increased vascular permeability. Four major clinical symptoms are recognized: skin reactions, smooth muscle spasm (gastrointestinal and genitourinary tracts and respiratory smooth muscle), respiratory distress, and cardiovascular collapse. Epinephrine is the drug of choice for the management. Its syrnpathomimetic effects directly counteract most aspects of the attack. Respiration must be immediately supported by the establishment of a patent airway along with artificial ventilation. The circulation should be supported and the existing hypotension overcome by placing the victim in a position to allow gravity to aid venous return and by administering intravenous fluids, vasopressors, and corticosteroids. When an imperceptible pulse is evident, external cardiac compression must also be instituted. This is a case report of anaphylactic shock care during general anesthesia, possibly due to penicillin, pancuronium and others.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.9-15
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• 2016

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

• 간호행정학회지
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• 제15권1호
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• pp.64-71
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• 2009

Purpose: This study shows the prehospital emergency nursing practices, and analyzes them associated with their individual characteristics and job conditions. Method: Based on a survey of the National Emergency Medical Center in Korea(2008), principal components were extracted from 7 prehospital emergency nursing practices by factor analysis, and some regression analyses of principal components(CPR-AED and V/S-I.V.) were executed on individual characteristics and job conditions. Results: The PENs gave themselves higher order ratings for vital sign check, airway management for loss of consciousness patients, CPR for suspicious cardiac arrest, keeping vein open for shock patients, AED for abnormal pulse rate, AED for suspicious cardiac arrest, and AED for loss of consciousness. Age and duty periods were statistically significant influential factors on the CPR-AED component. Conclusion: The results indicate that the PENs were competent in overall prehospital emergency activities and procedures even some weak self-evaluations, and that the standard curriculum and practice standard for prehospital nursing should be developed in order to increase nursing leadership in prehospital emergency settings.