• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.19.1-19.7
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• 2015

Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

• 한국산학기술학회논문지
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• 제14권10호
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• pp.4919-4926
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• 2013

본 연구는 보건계열 대학생의 스트레스가 신체적 증상 및 턱관절 증상에 미치는 영향을 파악하기 위하여 충남지역의 대학생 283명을 대상으로 2012. 9. 1부터 11.30일까지 실시하였다. 본 연구의 수집된 자료는 SPSS 18.0(SPSS 18.0 K for window, SPSS Inc, USA) 프로그램을 사용하여 분석하였다. 연구결과, 연령, 학년, 흡연, 간식섭취량은 스트레스에서 유의한 차이를 나타냈다. 성별, 학년, 음주, 간식섭취량 변화는 모두 소화증상에서 유의한 차이를 나타냈으며, 턱관절 장애는 성별에서 유의한 차이를 나타냈다. 스트레스, 신체적 증상 및 턱관절 증상 변수들 간에 양의 상관관계를 나타냈다. 스트레스는 신체적 증상 및 턱관절 증상에 영향을 미치는 것으로 나타났다. 따라서 보건계열 대학생들의 스트레스를 건전하게 해소할 수 있는 방안을 모색하고 대학생들의 신체 정신 건강과 구강건강을 예방하여 건전한 대학생활을 위한 대책이 필요하다.

• The Journal of Advanced Prosthodontics
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• 제6권6호
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• pp.539-546
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• 2014

PURPOSE. Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-$Gide^{(R)}$) using a rat calvarial defect model. MATERIALS AND METHODS. Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-$Gide^{(R)}$). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS. Bone regeneration was observed in the SF and Bio-$Gide^{(R)}$-treated groups to a greater extent than in the control group (mean volume of new bone was $5.49{\pm}1.48mm^3$ at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-$Gide^{(R)}$ samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks ($8.75{\pm}0.80$ vs. $8.47{\pm}0.75mm^3$, respectively, P=.592). CONCLUSION. SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.293-298
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• 2015

Objectives: Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacial infection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. Materials and Methods: This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. Results: Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of $35.0{\pm}19.3$ years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of $11.0{\pm}9.4$ days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. Conclusion: CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries.

• Safety and Health at Work
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• 제11권4호
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• pp.479-484
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• 2020

Background: The purpose of this study is to examine the combined effects of organizational climate (OC) with emotional labor (EL) on turnover intention in Korean firefighters. Methods: The data were obtained from the study Firefighters Research: Enhancement of Safety and Health. A total of 4,860 firefighters whose main duty was providing "emergency medical aid" were included. To examine the effects of OC on the relationships between five subscales of EL and turnover intention, four groups were created using various combinations of OC ("good" vs. "bad") and EL ("normal" vs. "risk"): (1) "good" and "normal" (Group I), (2) "bad" and "normal" (Group II), (3) "good" and "risk" (Group III), and (4) "bad" and "risk" (Group IV). Multivariate logistic regression analyses were performed to estimate the risk of turnover intention for the combinations of OC and EL. Results: The results showed turnover intention was significantly higher in the group with "bad" OC (17.7%) than in that with "good" OC (7.6%). Combined effects of OC and EL on turnover intention were found in all five subscales with the exception of Group I for emotional demands and regulation. Groups II, III, and IV were more likely to experience risks of turnover intention than Group I (p for trend <0.001). Conclusions: A positive and cooperative OC plays a role in decreasing the risk of turnover intention and in attenuating the negative effects of EL on turnover intention in firefighters.

• 대한통합의학회지
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• 제10권2호
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• pp.49-59
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• 2022

Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.

• Restorative Dentistry and Endodontics
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• 제48권3호
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• pp.31.1-31.11
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• 2023

Objectives: This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament. Materials and Methods: Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included. Results: Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249). Conclusions: Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

• Pediatric Infection and Vaccine
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• 제30권3호
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• pp.165-172
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• 2023

건강한 소아에서 화농성 간농양은 선진국에서는 드문 질환이지만 진단과 치료가 늦어진다면 치명적일 수 있는 질환이다. 전세계적으로 화농성 간농양의 가장 흔한 원인균은 Staphylococcus aureus이며 국내의 경우 Klebsiella pneumoniae가 가장 흔하지만, 혐기균에 의한 화농성 간농양도 매우 드물게 보고되고 있다. 발열과 우상복부 통증을 주소로 응급실에 온 14세 남아가 우상복부 압통을 보이고 백혈구 상승, 빈혈, 간효소치 상승을 보여 조영증강 복부컴퓨터단층촬영을 시행한 결과 간농양을 진단하였다. 환자는 2주간의 경피적 도관 배액술과 4주간의 항생제 치료 후 완쾌되었다. 간농양 배양검사에서 혐기균이자 구강 상재균인 Prevotella intermedia가 확인되었으나 감염의 근원이 치아조직 감염이라는 증거를 찾지는 못하였다. 본 증례와 같이 건강한 소아에서도 화농성 간농양이 발생할 수 있음을 염두에 두고 진단적 접근을 하는 것이 바람직하겠다.

• Journal of Oral Medicine and Pain
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• 제30권2호
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• pp.163-199
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• 2005

치의학계에서는 의료사고를 일으킬만한 중환자나 응급환자의 빈도가 상대적으로 낮아 의료분쟁에 휘말리는 경우가 적었기 때문에, 이에 대하여 비교적 안전지대로 인식되어 왔다. 그러나 요즈음은 남의 일로 보아 넘기기에는 어려울 정도로 의료분쟁이 증가하고 있다. 이런 연유로 최근에 이르러서는 비교적 다양한 의료사고와 분쟁에 관한 연구가 이루어지고 있으며, 적당한 대처를 위하여 관련된 사항을 분석하고 있으나, 자료가 부족한 실정이다. 본 연구는 2004년 현재 서울시치과의사회 소속 개원치과의사 3684명중, 설문지가 회수된 1882명을 연구대상으로 하며, 치과의사를 대상으로 하는 의료배상책임보험이 시행되고 있는 최근의 개원 치과에서 일어나는 의료사고 및 분쟁의 실태와, 일반적인 치과의사들의 의식을 분석하고, 전체적인 흐름을 파악하여 향후대책의 자료를 제시하는 것을 연구목적으로 한 것으로 다음과 같은 결과를 얻었다. 1. 응답자의 98.47%가 향후 의료사고 및 분쟁 발생에 대한 의구심을 가졌다. 2. 응답자의 27.42%가 의료분쟁을 경험하였으며, 전공의 수련여부와 의료분쟁 경험률 사이에는 유의한 차이가 나타나지 않았다. 3. 의료사고 중 치주.보존 관련 사고가 20.50%로 가장 높았으며, 임프란트 관련사고도 6.17%로 나타났다. 4. 응답자의 43.02%만이 치료 전 충분히 설명을 하였으며, 환자의 정확한 동의없이 치료를 시작하는 경우도 25.90%로 나타났다. 5. 설명 및 동의를 시행하지 않아 의료분쟁이 발생한 것은 16.55%이며, 의무기록 관련자료가 부족하여 문제해결에 어려움을 당한 경우는 10.26%로 나타났다. 6. 응급조치를 시행할 수 있다고 생각하는 경우는 49.73%였으며, 이중 정확한 지식을 갖춘 경우는 23.60%로 나타났다. 7. 의료분쟁 발생시 88.09%가 치과의사에게 조언을 구하였으며, 또한 단체로는 구치과의사회에 주로 자문을 구했다. 8. 의료분쟁과 관련하여 소비자보호원으로부터 자료 제출 요구를 받은 경우는 5.26%로 나타났으며, 이들 중 75.61%는 이에 성실히 대응하였다. 9. 의료분쟁을 해결한 후 83.63%는 비교적 안정적인 심리상태를 회복하였다. 10. 응답자의 99.46%가 의료분쟁처리기구가 필요하다고 느꼈으며, 78.58%는 매우 시급하다고 생각하였다. 11. 66.70%의 치과의사가 의료분쟁 경험이 없이도 의료배상책임보험에 가입하였다. 그러나 응답자의 73.36%는 이 상품에 대하여 잘 몰랐으며, 가입자의 93.36%는 분쟁처리과정을 잘 알지 못했다. 12. 79.00%의 응답자가 의료배상책임보험에 가입한 후에는 의료분쟁이 발생하여도 당황스러우나 가입 이전보다는 비교적 안심할 수 있다고 느끼고 있었다. 13. 의료배상책임보험에 의한 분쟁의 해결시 치과의사는 71.92%가 보통이상으로 만족하였으나, 환자는 35.61%만이 만족하였다. 14. 의료배상책임보험의 보완점으로 53.22%가 분쟁의 신속한 해결을 위해서 보험사, 의사, 환자 모두가 합의 유도에 동참해야 한다고 생각하였으며, 또 29.08%의 응답자가 합의과정에서 환자측의 업무방해를 보험사에서 방어해 주기를 바라고 있었다. 이상의 결과들을 볼 때 증가하는 의료분쟁에 대한 인식을 제고하고 이에 대한 교육 및 해결 장치의 보완이 필요할 것으로 사료된다.

• Child Health Nursing Research
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• 제2권1호
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• pp.112-126
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• 1996

The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.