• Title/Summary/Keyword: Anesthesia, general

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Effect Of Bioceramic Grafts With And Without eptfe Membrane In Periodontal Osseous Defects In Dogs (생체요업재료와 차폐막의 복합사용후 골연하 결손부의 재생효과)

  • Lee, In-Kyung;Lee, Ki-Young;Han, Soo-Boo;Ko, Jae-Sung;Cho, Jeong-Sik
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.47-67
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    • 1996
  • The purpose of this study was to observe the effect of $Biocoral^R$ graft and bioglass 45S5 graft in combination with ePTFE membrane in periodontal osseous defects for new bone formation. Nine healthy dogs were used. Under general anesthesia, 3-wall defects were created on the mesial and distal surfaces of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars. To induce periodontitis, a silicone rubber, $Provil^R$ light body, was injected under pressure into the defects. Ninety days later, $Provil^R$was removed and followed by thorough root planing. The followings were then applied in the mesial and distal defects of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars by random selections : 1) ePTFE membrane only application, 2) $Biocoral^R$ graft, 3) $Biocoral^R$ graft and ePTFE membrane application, 4)Bioglass 45S5 graft, 5) Bioglass 45S5 graft and ePTFE membrane application. The membranes were removed 1 month later. The dogs were sacrified at 1, 2 and 3 months following the graft, and block sections were made, demineralized, embedded, stained and examined by light microscope and transmission electron microscope. On the sections from teeth treated with ePTFE membrane only, the defect demonstrated extensive connnective tissue and alveolar bone regeneration. The $Biocoral^R$ graft group demonstrated extensive bone regeneration compared with ePTFE membrane only group. In the $Biocoral^R$ graft plus ePTFE membrane group, regeneration of new alveolus and crest occurred within the defect. As the experimental period lengthened, bone regeneration was increased and bone bridge was formed among the graft particles. The but bioglass 45S5 graft group demonstrated extensive bone regeneration but the amount of new bone was less than that of the $Biocoral^R$ graft group. For the bioglass 45S5 graft plus ePTFE membrane group, the amount of new bone was also increased. As the experimental period lengthened, bone regeneration was increased. Multinucleated giant cells, fibroblasts and macrophages were observed. As the bone formation was increased, the number of such cells was decreased. In conclusion, the $Biocoral^R$ was found better than the bioglass 45S5 for new bone formation, and the use of ePTFE membrane alone or with $Biocoral^R$/bioglass 45S5 can be supported as potential methods of promoting bone formation.

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Long-term Management of a Gingival Fibromatosis Patient with the Primary Dentition (유치열기에서 나타난 치은섬유종증 환자의 장기간 관리)

  • Kang, Chungmin;Lee, Jaeho;Choi, Hyungjun;Song, Jeseon;Kim, Seongoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.328-334
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    • 2014
  • Gingival fibromatosis is a rare oral condition that is characterized by proliferative fibrous overgrowth of the attached gingiva, the marginal gingiva, and the interdental papilla, typically presenting in the growth period. A case of a 27-month-old girl with a generalized severe gingival overgrowth is described herein. The patient had no known systemic disease, but enlarged gingival tissue had gradually covered her teeth. The excess gingival tissue was removed by conventional gingivectomy, which involved extraction of the retentive primary teeth under general anesthesia when she was 5 years old. Post surgical follow-up at 18 months after the surgery demonstrated no recurrence. Resectional surgery of the enlarged gingival tissue is the treatment choice for gingival fibromatosis, although there is a high risk of recurrence. More frequent professional follow-ups and oral hygiene instruction might be required. A delay in the surgical treatment may have significant consequences for the patient, such as primary dentition retention and consequent delay in the eruption of the permanent teeth, difficulties in mastication and phonation, malpositioning of the teeth, and psychological problems. Early surgical treatment should be performed according to the severity of enlargement.

Subcutaneous Emphysema and Inflammation of the Neck after Tracheal Puncture by an Intubating Stylet

  • Jung, Gul;Byun, Woo-Mok;Lim, Hyung-Jun;Kim, Jong-Gyun;Kwak, Dong-Min;Lee, Deok-Hee;Kim, Sae-Yeon;Song, Sun-Ok;Seo, Il-Sook;Jee, Dae-Lim;Kim, Heung-Dae;Park, Dae-Pal
    • 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.

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A Study of The Effect of Waiting time for Operation in the Operating Room on Preoperative Patients (수술환자에 있어 수술실내에서 수술대기 시간이 불안에 미치는 영향에 관한 연구)

  • Lee, Hea-Won;Lee, Kyu-Chung;Kim, Hae-Ock;Lee, Haik-Ock;Kim, Hea-Suk;Lee, Mi-Kyung;Song, Mal-Soon
    • The Korean Nurse
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    • v.29 no.3
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    • pp.36-48
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    • 1990
  • This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.

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Efficacy of Low Dose Barbiturate Coma Therapy for the Patients with Intractable Intracranial Hypertension Using the $Bispectral^{TM}$ Index Monitoring

  • An, Hung-Shik;Cho, Byung-Moon;Kang, Jeong-Han;Kim, Moon-Kyu;Oh, Sae-Moon;Park, Se-Hyuck
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.252-257
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    • 2010
  • Objective : Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with $Bispectral^{TM}$ index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. Methods : We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. Results : The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were $0.63{\pm}0.26$ in low dose group, and $1.31{\pm}0.48$ in high dose group. The treatment durations were $4.89{\pm}1.68$ days and $3.38{\pm}1.24$ days in low dose BCT and high dose BCT, respectively. Conclusion : It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.

Reconstruction of the Orbital Floor Fracture using the Antral Balloon Catheter with Radiopaque Dye (안저골절 정복술 후 풍선 달린 카테터와 방사선조영제의 이용)

  • Choi, Hwan-Jun;Lee, Han-Jung;Yang, Hyung-Eun;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.99-103
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    • 2010
  • Purpose: Blow-out fractures are reduced through transcutaneous or transconjunctival incisions. But the field of orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital floor, susceptibility of injury of orbital structures. In these situations, the former technique of using an antral balloon catheter has advantages over other methods for reconstruction because of its rapidity, simplicity, and inexpensiveness. Furthermore, the antral balloon catheter allows not only elevation of the orbital bone fragment but also expansion of the maxillary sinus in cases where there is a fracture of its walls. But postoperative follow-up method using computed tomography is expensive. Hence, we report a simple and inexpensive follow-up method using radiopaque dye inflation. Methods: We performed endoscopic transantral approach in 5 cases of blow-out fracture under general anesthesia. To accomplish this technique, a rigid 4 mm, 0 or 30 degree angled endoscopy was inserted into the maxillary sinus. Inflation of the catheter started gradually, with 10 to 15 mL of saline mixed radiopaque dye (saline: dye, 5 : 1) by syringe and while observing the elevation of the fracture site with endoscope until a proper contour was reached. For the maintain of the position of fractured site, 12 French urinary balloon foley catheter were used in fracture site for 7 - 10 days. Results: Postoperative assessment was performed by means of clinical and simple radiographic examination to secure the catheter under the inferior orbital wall and in the maxillary sinus. No specific complications occurred related to this procedure. Results of the surgery and follow-up in all cases were satisfactory. Conclusion: It may be a better alternative to the conventional follow-up method, with less cost and effectiveness of the catheter patency. The advantages of using the urinary balloon foley catheter with the radiopaque dye include the following : it is safe, efficacy, simple, and especially low cost. On drawback of this method is the discomfort to the patient caused by the catheter during the treatment.

Investigation of Dental Plaque, Calculus and Gingival Inflammation in Beagle Dogs (비글견에서 치태와 치석, 치은 염증의 조사)

  • Kim Joong-hyun;Ryu Hak hyun;Lee Jae yeong;Han Kyu-bo;Kim So-seob;Kang Seong soo;Bae Chun sik;Choi Seok hwa
    • Journal of Veterinary Clinics
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    • v.22 no.1
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    • pp.31-35
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    • 2005
  • This study was performed to investigate of dental plaque, calculus and gingival inflammation in Beagle dogs. Forty adults Beagle dogs (28 male and 12 female) were used in this study. The dogs weighed 9.5 kg and were in good oral and systemic health as determined by physical examination, and all dogs had full and normal dentition. The dogs were given a commercial pellet feed during 2 years period. For all examination procedures, the dogs were premedicated with a subcutaneous injection of atropine sulfate (0.04 mg/kg). Anesthesia was induced and maintained by intravenous administration of ketamine (8 mg/kg) and xylazine (2 mg/kg). Dental plaque, calculus and gingival inflammation were assessed by Logan and Boyce clinical plaque index. Calculi covering the maxillary carnassial and first molar teeth were extensive and were accompanied by severe gingival inflammation and pocket formation. Calculi, accompanied by gingival inflammation, were clearly evident on buccal surfaces of other teeth. Calculi didn't showed on the lingual surfaces, but linguogingival inflammation formed in premolar teeth. Although the general pattern was clear, there was considerable variation among dogs in the rate of deposition of calculus and extend of gingival inflammation. This investigation suggest that feeding of the commercial dry food without dental hygiene increase plaque accumulation and may be a contributing factor in calculi formation and periodontal disease.

Diagnosis and Treatment of Feline Inflammatory Polyp with Video Otoscopy : A Case Report (고양이에서 비디오 이경검사법을 이용한 염증성 폴립의 진단 및 치료 1례)

  • Park, Se-Jin;Lee, Seung-Yong;Kim, Young-Ki;Seok, Seong-Hoon;Hwang, Jae-Min;Jeong, Dong-Hyuk;Lee, Hee-Chun;Yeon, Seong-Chan
    • 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.

Augmentation of Pyriform Margin Using Porous High-Density Polyethylene Sheet In Unilateral Cleft Lip Nasal Deformity (일측성 구순열비변형에서 다공성 폴리에틸렌 판을 이용한 상악골이상구증대술)

  • Han, Ki Hwan;Kim, Jin Han;Choi, Tae Hyun;Kim, Jun Hyung;Son, Dae Gu
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.431-438
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    • 2008
  • Purpose: The common deformity after the correction of unilateral cleft lip nasal deformity is nasal asymmetry, and it is caused by the hypoplasia of the pyriform aperture. To correct this, many procedures have been applied, but still many problems are present. Authors performed the inlay and onlay insertion of porous high density polyethylene sheet(1 mm thickness $Medpor{(R)}$ sheet) in the hypoplastic pyriform margin of cleft side and obtained satisfactory results. Methods: 11 cases were performed and the mean follow up period was 15.1 months. Their mean age was 23.6 years. Under general anesthesia, bilateral pyriform margin was exposed. $Medpor{(R)}$ sheets in "match stick" like shaped were inlay inserted, and kidney shaped were onlay inserted fixating with two 6 mm titanium screws. After the surgery, the results was evaluated by photogrammetric analysis. On the basal view, the distance from the subalare and labiale superius' to the transverse baseline connecting the both cheilions was measured from the cleft side and the non-cleft side. Then, the postoperative symmetry was assessed by obtaining the cleft side against the non-cleft side as proportion index, defined as lateral and medial upper lip contour index. Results: There were 2 infections. The cause was because the inserted implant was too long and thus protruded to the base of nasal cavity. The lateral upper lip contour index was from 95.49 to 103.27, and medial upper lip contour index was from 90.92 to 100.49, it was statistically increased, and thus the symmetry was improved. However clinically mild depression remained at nostril floor. Conclusion: Authors performed porous high density polyethylene sheet inlay and onlay insertion for the hypoplasia of the pyriform margin in unilateral cleft lip nasal deformity. It was found that depressed pyriform margin and upper lip were corrected effectively except for the nostril floor, for which an additional soft tissue augmentation would be necessary. The inlay insertion has risk of protrusion, thus the guideline of the use of artificial prosthesis should be observed strictly.

The Effective Reduction Method of Unstable Zygomatic Arch Fracture with Thermo-Splint (Thermo-splint를 이용한 불안정한 관골궁골절에 대한 효과적인 고정방법)

  • Kim, Sun Heum;Lee, Soo Hyang;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Song, Wu Chul
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.110-115
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    • 2008
  • Purpose: The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture. Methods: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo-splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively. Results: In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint. Conclusion: The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.