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전신질환자에서 과도한 감염치아 발치시 스트레스 감소법 : 문헌적 고찰 및 증례보고 (STRESS REDUCTION PROTOCOL FOR PROPER EXTRACTION OF ADVANCED INFECTED TEETH IN MEDICALLY COMPROMISED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES)

  • 유재하;최병호;홍순재;남웅;김종배;윤정훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권1호
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    • pp.85-92
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    • 2000
  • Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

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다발성 전신질환 장애환자에서 진행성 치성감염에 의한 측두간극농양 절개 배농시 창상주위 봉합과 배농술에 의한 과도한 출혈조절 : 증례보고 (BLEEDING CONTROL BY THE CIRCUMFERENTIAL SUTURE & DRAINAGE ON ACTIVE BLEEDING INCISION & DRAINAGE SITE OF TEMPORAL SPACE ABSCESS DUE TO ADVANCED ODONTOGENIC INFECTION IN A MULTIPLE MEDICALLY COMPROMISED DISABLED PATIENT : REPORT OF A CASE)

  • 손정석;오지현;유재하
    • 대한장애인치과학회지
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    • 제9권1호
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    • pp.30-35
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    • 2013
  • The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

Bio-Oss 골이식이 치아맹출에 미치는 영향에 관한 동물실험 연구 (Effect of Bio-Oss grafts on tooth eruption: an experimental study in a canine model)

  • 김지훈;장채리;최병호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권6호
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    • pp.528-532
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    • 2010
  • Introduction: There are few reports on tooth eruption through Bio-Oss grafts. To our knowledge, there are no reports on whether teeth can erupt normally through the grafts. The aim of this study was to examine the effect of Bio-Oss grafts on tooth eruption in a canine model. Materials and Methods: In five 10-week-old dogs, the deciduous third mandibular molars in one jaw quadrant of each animal were extracted and the fresh extraction sockets were then filled with Bio-Oss particles (experimental side). No such treatments were performed on the contralateral side (control side). A clinical and radiological evaluation was carried out every other week to evaluate the eruption level of the permanent third mandibular premolars and compare the eruption levels between the two sides. Results: At week 4 after the experiment, the permanent third premolars began to erupt on both sides. At week 12, the crown of the permanent third premolar emerged from the gingiva on both sides. At week 20, the permanent third premolars on both sides erupted enough to occlude the opposing teeth. No significant differences were found between the control and experimental sides in terms of the eruption speed of the permanent third molars. Conclusion: These findings demonstrate that the grafting of Bio-Oss particles into the alveolar bone defects does not affect tooth eruption.

관악기 연주자의 치주상태에 관한 연구 (CLINICAL STUDY ON THE EFFECT OF WIND INSTRUMENT PLAYING ON PERIODONTAL CONDITIONS)

  • 이원유;최성호;김성희
    • Journal of Periodontal and Implant Science
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    • 제24권2호
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    • pp.390-396
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    • 1994
  • This study investigates the effect of wind instrument playing on the periodontal condition by comparing and analyzing wind instrument players and non-wind instrument players by various clinical paramenters, including periodontal index, bleeding index, simplified oral hygiene index, and non-functional tooth index. The subjects consist of 65 wind instrument players and 31 non-players. The players were divided into 4 groups ; Those who use cup-shaped mouthpieces as Group A, single reed mouthpieces as Group B, double reed mouthieces as Group C, and hole mouthpieces as Group D. Non-players are designated as Group E. The results are as follows ; 1. Periodontal Index Group A recorded $1.2{\pm}0.7$, Group B $1.1{\pm}0.7$, Group C $1.3{\pm}0.5$, Group D $2.1{\pm}0.5$, and Group E $0.9{\pm}0.6$, with no statistically significant differences among the groups. 2. Bleeding Index Group A shwed 0.23, Group B 0.25, Group C 3.0, Group D 0.38, and Group E 0.23, with no statistically significant differences among the groups. 3. Non-functional Tooth Index Group A recorded 2.0, Group B 1.0, Group C 3.0, Group D 0, Group E 0.7, with no statistically significant differences among the groups. 4. Simplified Oral Hygiene Index Buccal sides of maxillary 1st molars, lingual sides of mandibular 1st molars, labial sides of maxillary anterior teeth, and lingual sides of mandibular anterior teeth were investigated, and there was no statistically significant differences among the groups.

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임상에서 부모-교사 보고의 일치 : SDQ-Kr과 K-CBCL의 비교 (Agreement between Parent and Teacher Reports in Clinical Setting : Comparing SDQ-Kr with K-CBCL)

  • 김흥규;안정숙;김민혁
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제23권3호
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    • pp.127-133
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    • 2012
  • Objectives : The aims of this study were to examine agreement between parent and teacher ratings of the Korean version Strengths and Difficulties Questionnaire (SDQ-Kr) for the children's psychopathology and to determine whether it is effective in diagnostics as the Korean version of Childhood Behavior Checklist (K-CBCL). Methods : SDQ-Kr and K-CBCL were completed by parents and teachers of 165 children aged 6-12 years. The clinical diagnosis was made by a child and adolescent psychiatrist who did not have knowledge of the outcome. Spearman's correlations were computed for associations between parents' and teachers' ratings on a subscale level. The Mann-Whitney U test was performed for the influence of child's age and sex on the results. Finally, AUC values were calculated for the diagnostic capacity and the difference between informants was tested using the z test. Results : High correlations were observed between parents' and teachers' SDQ-Kr on every scale. Parents were more sensitive to emotional symptoms of girls, while teachers appeared to be more responsive to externalized symptoms of boys, inattention-hyperactivity of young children, and emotional symptoms of seniors. Parents' SDQ-Kr demonstrated the highest prediction of attention-deficit hyperactivity disorder. Conclusion : Teachers' SDQ-Kr can be used in identification of child psychopathology when parents are absent or when their reliability is considered low.

유리피판술을 이용한 족부재건 (Microvascular Reconstruction of Extensive Foot Injuries)

  • 정윤규;정섬;김주봉
    • Archives of Reconstructive Microsurgery
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    • 제3권1호
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    • pp.64-71
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    • 1994
  • 해부학적으로 족부는 주위에 이용할 수 있는 연주 조직이 별로 없을 뿐 아니라 이용할 수 있더라도 크기가 제한되어 있으므로 광범위한 연부조직 결손시 이의 복원이 어렵다. 광범위하고 오염된 족부의 창상을 재건시 이상적인 조직의 조건으로서는 감염에 잘 견디고, 가능한한 원래의 모양 및 크기에 가깝게 복원해야 하며, 적절한 감각이 있어야 하고, 끊임없는 마찰력과 체중 부하에 잘 견뎌야 할 것이다. 미세혈관술을 이용한 유리조직이식은 비교적 위와같은 장점들을 제공할 수 있다. 저자들은 최근 약 4년간 외상과 전기화상 및 화상후 후유증으로 인하여 족배부, 발꿈치, Achilles건, 족저부등에 광범위한 결손 및 변형이 있었던 환자 21예에서 미세혈관술을 이용하여 Fasciocutaneous, musulocutaneous, muscle with skin graft 등으로 족부를 재건하여 추적중에 있으며 현재까지 관찰된 결과 및 장점, 단점과 문제점들을 보고하는 바이다.

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Anti-inflammatory Effect of Mangosteen (Garcinia mangostana L.) Peel Extract and its Compounds in LPS-induced RAW264.7 Cells

  • Widowati, Wahyu;Darsono, Lusiana;Suherman, Jo;Fauziah, Nurul;Maesaroh, Maesaroh;Erawijantari, Pande Putu
    • Natural Product Sciences
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    • 제22권3호
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    • pp.147-153
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    • 2016
  • Inflammation plays an important role in host defense against external stimuli such as infection by pathogen, endotoxin or chemical exposure by the production of the inflammatory mediators that produced by macrophage. Anti-inflammatory factor is important to treat the dangers of chronic inflammation associated with chronic disease. This research aims to analyze the anti-inflammatory effects of Garcinia mangostana L. peel extract (GMPE), ${\alpha}$-mangostin, and ${\gamma}$-mangostin in LPS-induced murine macrophage cell line (RAW 264.7) by inhibiting the production of inflammatory mediators. The cytotoxic assay of G. mangostana L. extract, ${\alpha}$-mangostin, and ${\gamma}$-mangostin were performed by MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) to determine the safe and non-toxic concentration in RAW 264.7 for the further assay. The concentration of inflammatory mediators (COX-2, IL-6, and IL-$1{\beta}$) were measured by the ELISA-based assay and NO by the nitrate/nitrite colorimetric assay in treated LPS-induced RAW 264.7 cells. The inhibitory activity was determined by the reducing concentration of inflammatory mediators in treated LPS-induced RAW 264.7 over the untreated cells. This research revealed that GMPE, ${\alpha}$-mangostin, and ${\gamma}$-mangostin possess the anti-inflammatory effect by reducing COX-2, IL-6, IL-$1{\beta}$, and NO production in LPS-induces RAW 264.7 cells.

Investigation on deck-stay interaction of cable-stayed bridges with appropriate initial shapes

  • Liu, Ming-Yi;Lin, Li-Chin;Wang, Pao-Hsii
    • Structural Engineering and Mechanics
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    • 제43권5호
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    • pp.691-709
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    • 2012
  • This paper provides a variety of viewpoints to illustrate the mechanism of the deck-stay interaction with the appropriate initial shapes of cable-stayed bridges. Based on the smooth and convergent bridge shapes obtained by the initial shape analysis, the one-element cable system (OECS) and multi-element cable system (MECS) models of the Kao Ping Hsi Bridge in Taiwan are developed to verify the applicability of the analytical model and numerical formulation from the field observations in the authors' previous work. For this purpose, the modal analysis of the two finite element models are conducted to calculate the natural frequency and normalized mode shape of the individual modes of the bridge. The modal coupling assessment is also performed to obtain the generalized mass ratios among the structural components for each mode of the bridge. The findings indicate that the coupled modes are attributed to the frequency loci veering and mode localization when the "pure" deck-tower frequency and the "pure" stay cable frequency approach one another, implying that the mode shapes of such coupled modes are simply different from those of the deck-tower system or stay cables alone. The distribution of the generalized mass ratios between the deck-tower system and stay cables are useful indices for quantitatively assessing the degree of coupling for each mode. These results are demonstrated to fully understand the mechanism of the deck-stay interaction with the appropriate initial shapes of cable-stayed bridges.

양측성 상완이두장건 결손과 견관절 불안정성 - 증례 보고 - (Shoulder instability with congenital absence of bilateral long head of biceps tendon - A Case Report -)

  • 나중호;정회정;김두섭
    • 대한관절경학회지
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    • 제14권3호
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    • pp.188-191
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    • 2010
  • 상완이두장건의 결손은 매우 드문 이상이다. 본원에 내원한 19세 남환은 우측 견관절 아탈구 증상을 주소로 내원하였다. MRI 상 상완골의 얕은 결절사이고랑이 관찰되었으며 상완이두장건의 결손이 관찰되었다. 견관절 내시경술을 시행하였으며 관절와순 파열과 함께 상완이두장건의 결손이 관찰되었다. 5개월 뒤 좌측 견관절에도 우측 견관절과 같은 증상이 발생하였고 MRI 및 견관절 내시경 소견 상 상완이두장건의 결손 소견 및 관절와순 파열 소견이 관찰되었다. 양측 견관절 모두 내시경적 관절와순 봉합술을 시행하였으며 수술 후 위팔 외전 보조기를 이용하여 고정하였다. 상완이두장건의 결손이 견관절의 불안정성을 유발할 수 있을 것이라고 생각한다.

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Reconstruction of cutaneous defects of the nasal tip and alar by two different methods

  • Kim, Yong Hun;Yoon, Hyung Woo;Chung, Seum;Chung, Yoon Kyu
    • 대한두개안면성형외과학회지
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    • 제19권4호
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    • pp.260-263
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    • 2018
  • Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape. Methods: We analyzed 36 patients with skin tumors who underwent flap coverage after tumor ablation. Rotation flaps were used in 26 cases and croissant-shaped V-Y advancement flaps were used in 10 cases. The primary cause of the defects was skin cancer, except for one benign tumor. Results: The mean patient age was 71 years. The size of the defects ranged from $0.49cm^2$ to $3.5cm^2$. No recurrence of skin cancer was noted and all flaps lasted until the end of follow-up. Partial desquamation of the epidermis was noted in one case. The postoperative appearance for most patients was excellent, objectively and subjectively. Conclusion: For cutaneous defects of up to about $4.0cm^2$ of the alar and nasal tip, local flaps using our methods offered a good cosmetic and therapeutic result. The main advantage of our flaps is the minimal dissection required compared to bilobed and other local flap methods. We believe our flaps are a suitable option for alar and nasal tip reconstruction.