• 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.

• 대한영상의학회지
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• 제79권6호
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• pp.340-347
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• 2018

목적: 가도세틱산-조영증강 MRI에서 간세포암 피막 발견에 대한 영상차감기법의 진단적 가치를 알아보고자 하였다. 대상과 방법: 2015년 5월부터 2017년 2월까지 가도세틱산-조영증강 MRI를 시행 받고 수술을 시행한 hepatocellular carcinoma (이하 HCC) 고위험군 108명을 대상으로 하였다. 차감영상의 질 및 간문맥기와 이행기의 일반영상과 차감영상에서 피막 여부에 대해 평가하였고, 차감영상에서의 피막 여부가 Liver Imaging Reporting and Data System에 따른 간세포암 진단에 미치는 영향을 평가하였다. 결과: 수술 전 경동맥화학색전술을 시행 받았거나 차감영상의 질이 불만족스러운 34명의 환자를 제외한 74명의 환자에서 82개의 간 병변(간세포암 73개, 그 외 악성종양 5개, 양성종양 4개)에 대해 분석하였다. 피막의 발견에 대한 차감영상의 민감도, 정확도, 그리고 곡선하면적은 일반영상과 비교하여 통계적으로 유의하게 높았고(각 95.4%, 89.0%, 0.80; p < 0.001), 특이도는 동일하였다(64.7%). HCC의 진단에 대해서도 차감영상이 일반영상과 비교하여 민감도, 정확도, 그리고 곡선하면적이 통계적으로 유의하게 높았으며(각 82.2%, 79.3%, 0.69; p = 0.011), 특이도는 동일하였다(55.6%). 결론: 가도세틱산-조영증강 MRI에서 간문맥기 또는 이행기로부터의 차감영상은 간세포암 피막의 발견에 도움이 된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.157-161
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• 2017

In sedation via the submucosal route, the drug is administered through the maxillary buccal submucosa. It is time saving, effective, and safe. Patients with autism, a mental disorder, often find it hard to make relationships with other people. These patients display a strong resistance to dental treatment and sedation. This study reports a successful case of behavioral management during dental treatment, using sedation via the submucosal route. The patient was strongly resistant to sedation via the oral, intramuscular, and intravenous routes. The drug used was 9 mg (0.1 mg/kg) of midazolam. Through this case report, we reaffirm the significance of sedation via the submucosal route, and expect that it will be used more frequently for patients with autism, who display behaviors that are difficult to manage, patients with other disabilities, and children.

• 환경위생공학
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• 제24권4호
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• pp.39-48
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• 2009

This paper investigated an overview of awareness for fluoride in the young christian association. 30% of men and 70% of women knew well the prevention of caries for fluoride and water fluoridation program and showed of 90% in 20's, 10% in 30's and 0.00% in 40's. 54%-known people for fluoride had each 37% of men and 63% of woman, then 46%-unknown people for fluoride had each 56.52% of man and 43.48% of women. This showed women knew well awareness for fluoride than men. This showed high level above 50% awareness for fluoride as 54% of comprehension for fluoride and 50% of water fluoridation program. Awareness of fluoride of the subjects known for fluoride, prevention of caries, effects of tooth and water fluoridation program appeared above 50% level as 54%, 47%, 45% and 50%, individually. Thus, tooth management in christian showed high level. But, awareness for fluoride of women in third condition 'unknown for mottled tooth' showed each 38%, 34% and 37%. The mottled tooth from an excessive fluoride appeared low level awareness for fluoride of women. It suggested hard scientific contents made woman subjects unknown the effects of fluoride for tooth.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2000년도 제52차 추계학술대회 연제집
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• pp.240-241
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• 2000

• 대한장애인치과학회지
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• 제8권1호
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• pp.15-21
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• 2012

Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.471-477
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• 2001

Failure to use effective methods of reduction, fixation, and immobilization may lead to nonunion with osteomyelitis, owing to the compound nature of most fractures of the mandible. Nonunion results in fibrous pseudoarthrosis at the fracture site with instability that, once formed, does not improve spontaneously. Once the nonunion with osteomyelitis secondary to fractures has become established, intermaxillary fixation and drainage of infected tissue should be instituted as early as possible, because the fixation & drainage enhances the patient comfort and hinders ingress of microorganisms & debris by movement of bone fragments. The authors treated three cases of nonunion with osteomyelitis by intermaxillary fixation, incision & persistent drainage on the previous fistula site and endodontic drainage of infected teeth in the fracture site of mandible. The localization & sequestration of the infected bone around the fracture was better performed persistently by natural homeostatic mechanism in $8{\sim}10$ weeks and the bony union was then attained without bone grafting.

• 기본간호학회지
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• 제23권4호
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• pp.419-429
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• 2016

Purpose: The purpose of this study was to examine the effects of a intensive clinical training program for nursing practice on the clinical competence, state anxiety, clinical practice stress in nursing students who were beginning their first clinical practice. Methods: This practice has been processed as a 'Pre-Post design with a non-equivalent control group'. The participants were 177 students in a college of nursing. The students were divided into two groups: 89 students in the experimental group and 88 students in the control group. Results: The experimental group showed significant improvement in their clinical competence scores compared to the control group. The difference between the two groups was also significant. State anxiety in the experimental group significantly decreased compared to the control group. However, scores for stress during practice were not significantly different. Conclusion: The findings in this research reveal that the program, 'Close clinical practice training for nursing students' practice entry, contributes to improving students' overall ability and performance, and reduces anxiety of nursing students as they start their first clinical practice. These findings can be utilized in helping nursing students improve the quality of their performance.

• 대한장애인치과학회지
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• 제8권2호
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• pp.134-138
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• 2012

In treatment of dentigerous cyst, complete enucleation, histopathologic examination and postoperative care are important to prevent the potential complications (mural ameloblastoma, squamous cell carcinoma). On the other hand, a maxillary impacted supernumerary anterior tooth are removed surgically, owing to the possibility of the cyst formation in future. After the cyst enucleation and extraction of the involved tooth, the wound area sutured and removable resin plate is then applied. In this operation, the postoperative bleeding and infection is likely to occur owing to postoperative accumulation of hematoma & seroma, psychologic stress and other contaminated factor. So, the authors established the immediate rubber & iodoform gauze drainage into the sutured wound of cyst enucleation & tooth extraction for the prevention of postoperative bleeding and infection. The removable resin splint are not used because of the poor cooperation and economic factor. The results were more favorable without the postoperative bleeding & wound infection in a cerebral palsy patient.

• 대한치과마취과학회지
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• 제10권2호
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• pp.203-208
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• 2010

Tremors are trembling movements and are seen in association with alcoholic intoxication, certain drugs, thyrotoxicosis, multiple sclerosis, hysteria, and nervous tension. Dental fears, such as, pain, drill, unknown, dependency, helplessness, mutilation and oral change, induce the neuroendocrine response (release of epinephrine and norepinephrine, etc). The clinical manifestations of epinephrine or other vasopressor overdose include : anxiety, tenseness, restlessness, throbbing headache, tremor, perspiration, weakness, dizziness, pallor, palpitation and respiratory difficulty. Signs of local anesthetic overdose appear clinically whenever the anesthetic level in the blood rises to an appropriate level in an individual. The clinical signs of moderate overdose levels include : talkativeness, apprehension, excitability, slurred speech, tremor and muscular twitching. This is a case report about the severe tremor care after the endodontic treatment under right mandibular block anesthesia in a 56-years old female patient.