• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.87-91
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• 2016

Pierre Robin syndrome (PRS) is characterized by the triad of congenital mandibular hypoplasia, glossoptosis and cleft palate. Infant PRS patients are frequently suffering from upper airway obstruction, gastroesophageal reflux and growth retardation caused by above mentioned problems. We report a dental caries treatment of 3-year old girl with Pierre Robin syndrome with multiple caries. The cause of multiple caries was mainly presumed as patient's eating habit caused by her general condition. She had some feeding problems and had history of gastric tube. She was still using milk bottle and took more than an hour to finish a meal. The treatment was performed under general anesthesia considering patient's condition; mild autism, poor cooperation and respiratory problem due to micrognathia. Severely affected upper incisors were treated with pulp treatment and restored with zirconia crown for esthetic purpose. Lower incisors were treated with pulp treatment and restored with composite resin. Upper right first primary molar was restored with stainless steel crown and other primary molars were treated with composite resin. There were no postoperative complications. According to her parents, the patient's compliance to oral hygiene management was greatly improved after the treatment since she was very pleased with the esthetic result and highly motivated by her looks. The treatment without sedation or general anesthesia would be possible once the airway is improved as the mandible grows.

• IMMUNE NETWORK
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• v.22 no.5
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• pp.40.1-40.24
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• 2022

Mesenchymal stem cells (MSCs) are attractive alternatives to conventional anti-asthmatic drugs for severe asthma. Mechanisms underlying the anti-asthmatic effects of MSCs have not yet been elucidated. This study evaluated the anti-asthmatic effects of intravenously administered MSCs, focusing on macrophages and monocytes. Seven-week-old transgenic (Tg) mice with lung-specific overexpression of IL-13 were used to simulate chronic asthma. MSCs were intravenously administered four days before sampling. We examined changes in immune cell subpopulations, gene expression, and histological phenotypes. IL-13 Tg mice exhibited diverse features of chronic asthma, including severe type 2 inflammation, airway fibrosis, and mucus metaplasia. Intravenous administration of MSCs attenuated these asthmatic features just four days after a single treatment. MSC treatment significantly reduced SiglecF^-CD11c^-CD11b⁺ monocyte-derived macrophages (MoMs) and inhibited the polarization of MoMs into M2 macrophages, especially M2a and M2c. Furthermore, MSCs downregulated the excessive accumulation of Ly6c^- monocytes in the lungs. While an intravenous adoptive transfer of Ly6c^- monocytes promoted the infiltration of MoM and Th2 inflammation, that of MSC-exposed Ly6c^- monocytes did not. Ex vivo Ly6c^- MoMs upregulated M2-related genes, which were reduced by MSC treatment. Molecules secreted by Ly6c^- MoMs from IL-13 Tg mice lungs upregulated the expression of fibrosis-related genes in fibroblasts, which were also suppressed by MSC treatment. In conclusion, intravenously administered MSCs attenuate asthma phenotypes of chronic asthma by modulating macrophages. Identifying M2 macrophage subtypes revealed that exposure to MSCs transforms the phenotype and function of macrophages. We suggest that Ly6c^- monocytes could be a therapeutic target for asthma management.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.2
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• pp.63-71
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• 2018

Prosthetic restorations through implants were popularized, and they became routine treatments. Small accessories used in the implant prosthodontic procedure are more likely to slip or fall off the dentist's hands. If the dental appliance or material passes into the upper gastrointestinal tract, there is a high possibility of excretion to the outside of the body without complications, but serious complications may occur depending on the type of foreign body. If the foreign body is passed to the airway, it is an emergency situation, and if it is not done properly, it can be fatal. The purpose of this review report is to investigate the process of foreign body ingestion or aspiration during dental treatment, and the method of prevention and treatment.

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.8-15
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• 1996

When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

• Journal of The Korean Dental Society of Anesthesiology
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• v.2 no.2 s.3
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

• Korean Journal of Adult Nursing
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• v.14 no.2
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• pp.265-275
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• 2002

Pursose: The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. Method: The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky & Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. Result: The results of this study are as follows. 1. The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2. Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3. Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. Conclusion: The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.351-355
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• 2000

Penetrating injuries in the head and neck region are not common but can pose difficult situations to manage properly. In small cross-sectional area, the neck housed many vital structures, such as carotid artery, internal jugular vein, cervical spines, esophagus, laryngotracheal complex and nerves. Because each vital structure is located within the fascial compartments, bleeding into these closed spaces can give rise to compression of surrounding structures, which may result in compromised airway. Therefore, management of the penetrating injuries should be based on the fully understanding of anatomical relationships, accurate clinical examinations, a careful history taking and the proper treatment planning. We present two cases of penetrating injuries in the head and neck region and discuss on the clinical considerations for the proper management with the literature review.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.7.2-8
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• 1983

Chronic laryngotracheal stenosis is becoming increasingly prevalent. Many acceptable procedures such as repeated dilation, laryngotracheoplasty and end-to-end anastomosis had been done according to it's indication, but it have given less than favorable results. Since 1972 the experimental and clinical experiences of Jako and Strong, the carbon dioxide laser has offered a valuable tool to the otolaryngologist. Mihashi (1976) and Lyons (1980) reported use of laser to the management of laryngotracheal stenosis with successful results. From April 82' to March 83', using the carbon dioxide laser, the various obstructing lesions were excised microendoscopically which include four patients considered failures from conventional surgical technique and one patient laryngeal stenosis occured after hemilaryngectomy and neoglottis formation. We concluded as follows, 1) Laser surgery is a useful method to the management of laryngotracheal stenosis in maintaining adequate airway. 2) Formation of granulation after laser surgery was less than other conventional methods.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.