• 대한치과마취과학회지
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• 제14권1호
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• pp.29-39
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• 2014

Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

• 대한소아치과학회지
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• 제44권2호
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• pp.243-255
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• 2017

심폐소생술(cardiopulmonary resuscitation, CPR)은 심장의 기능이 정지하거나 호흡이 멈추었을 때 인공적으로 혈액을 순환시키고 호흡을 보조해 주는 응급처치이다. 심폐소생술은 기본생명구조술(basic life support, BLS)과 전문소생술(advanced life support, ALS)로 나눌 수 있다. 기본생명구조술은 주요 조직으로 혈류 공급을 강제적으로 하기 위한 흉부압박과 호흡정지 환자에게 구조호흡(rescue breathing) 그리고 심실세동을 개선해 주기 위한 자동제세동기(automated external defibrillator, AED)이 포함된다. 전문소생술의 범주는 성인을 대상으로 하는 고급생명구조술(advanced cardiovascular life support, ACLS)과 소아를 대상으로 하는 소아고급생명구조술(pediatric advanced life support, PALS)이 있다. 치과 치료에 극심한 공포를 가지며, 여러 이유로 치과 진료에 협조를 얻기 어려운 소아를 대상으로 하는 치료환경에서는 약물을 이용한 진정법이 고려된다. 이는 심정지를 포함한 응급상황이 발생할 가능성이 증가하는 이유가 된다. 소아고급생명구조술은 기본생명구조술을 포함하며, 심정지에 이를 수 있는 원인을 호흡, 순환장애 그리고 심인성으로 나누어 대처하는 체계적인 방법을 제시한다. 소아는 성인에 비해 심인성의 원인은 낮지만, 해부학적인 약점으로 인해 호흡이나, 순환장애에 의한 심정지의 가능성은 높다. 따라서, 스트레스를 많이 받은 아이를 치료하거나 진정법을 시행하는 소아치과의사는 소아고급생명구조술을 익힘으로써 응급상황에 적절히 대처할 수 있는 역량을 갖출 수 있으리라 사료된다.

• 한국치위생학회지
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• 제6권3호
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• pp.243-261
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• 2006

Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

• 대한치과마취과학회지
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• 제3권1호
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• pp.34-37
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• 2003

Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

• 부모자녀건강학회지
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• 제6권2호
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• pp.147-158
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• 2003

The purpose of this study was to investigate the situation of occurrence of disease and accidence of child care center. The subjects of this study were 17 public district child care centers, but only one center kept their health diary. Therefore, it became finally the only subject for this study. The data were collected through the analysis it's health diary and case reports for emergency. The collected data were analyzed by the number of cases, age and sex, types of case, and the emergency case were analyzed by age, background, types of accidents and follow up. The number of cases of disease and accident in 2002 were 572. In sexual difference, boys more have accident than girls. The teachers and the outsiders also frequently use the health care service. Smallpox and epidemic conjunctivitis were spreaded during winter and summer. In causes of accidents, 'accident by other child' were 98%. In emergency cases, 1 pierced wound, 1 dislocation, 2 dental emergencies, 4 eyeball contusion and bleedings and 2 burns were occurred. all the cases of emergency were performed follow up education. On the basis of above data, there will be needed to intensify health and safety subjects in curriculum for the teacher of child care, and health and safety education for child. Each child care centers must have health care manager and the network for emergency. To enhance the quality of child care service, government have to offer financial and systematical support.

• 한국응급구조학회지
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• 제23권1호
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• pp.87-99
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• 2019

Purpose: The aim of this study was conducted to assess the proficiency of both direct laryngoscopy and video laryngoscopy and the usefulness of each laryngoscope, thereby provide basic data for further education using video laryngoscopy. Methods: Forty one paramedic subjects participated in this study. Usability was measured with the System usability scale. The Macintosh direct laryngoscope and $C-MAC^{(R)}$ video laryngoscope were two instruments evaluated in the study. Results: Training with video laryngoscopy showed significantly better results within the categories of dental injury (p=.004), esophageal intubation (p=.001), and proper depth placement of intubation tubes (p=.019). The results of the System usability scale questionnaire and the degrees of visibility based on the Cormack & Lehane classification were also found to be better achieved with the video laryngoscopy (p=.000). Conclusion: This study suggests enhancing education with video laryngoscopy, which could reduce the risk of complications and duration of intubation while increasing the success rate among students and emergency medical technicians with little experience, rather than the existing method of only using direct laryngoscope, which requires considerable experience and skills.

• 대한치과의사협회지
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• 제22권5호통권180호
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• pp.387-392
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• 1984

외상의 처치는 일반적으로 응급처치기(emergency 혹은 initial phase), 중간처치기 (intermidiate 혹은 planning phase) 그리고 항구치료기 (definitive phase)로 구분되며 응급처치의 범주내에서는 우선 환자의 생명유지를 고려하고 다음엔 창의 생활력(vitality)을 유지하여 장차의 조직결손과 기능적 결합을 예방하는 데 목적이 있다. 그러므로 구강 및 악안면의 광범한 외상은 기도확보, 대량실혈의 방지, shock의 예방 (수액보충 등) 및 감염대책 등의 순으로 응급대처하게 된다. 그러나 일반 개원임상의들이 자주 접하는 비교적 작은 외상에서는 위의 대원칙에 더하여 창상의 효과적인 1차적 처치에 더욱 관심을 갖어 조직의 괴사나 결손 및 변형으로 인한 기능적 심미적 장애를 최솔 하는 것이 중요하다.

• 대한치과의사협회지
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• 제54권10호
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• pp.790-798
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• 2016

The maxillofacial soft tissue trauma is one of the major causes to visit the emergency room. For the past few decades, however, the basic concept of the repairing the soft tissue wound have not been changed. Therefore, it could be worthwhile to remind the fundamental concepts and practical information belong to the soft tissue injury management. Among the many types of soft tissue trauma, laceration wound which is most frequently met in the clinic will be discussed in this review.

• 대한치과의사협회지
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• 제38권12호통권379호
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• pp.1172-1177
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• 2000

Eighty nine-year-old female patient admitted to our department via emergency room. On initial exam, she showed right facial swelling, irismus, pain, and poor oral hygiene. Tentative diagnosis was facial cellulitis. In spite of aggressive treatment such as antibiotic, incision and drainage, medically intensive therapy, she was dead with cardiopulmonary arrest and sepsis.

• 한국응급구조학회지
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• 제24권1호
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• pp.103-115
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• 2020

Purpose: This descriptive study investigated the relationship between death awareness and life ethics awareness, according to life stress, among students in the department of paramedics. Methods: General characteristics were identified using means and frequency, and the differences between the two military models were analyzed using the χ²-test and t-test by dividing them into lower and higher groups based on the mean life stress score (99.76 points). Results: Those with high life stress had higher death awareness than those with low life stress at 114.11 points. In contrast, those with low life ethics experienced more severe life stress with a score of 145.61 points (t=-2.609, p=.010)(t=-2.953, p=.003). The death recognition attitude and bioethics according to the degree of living stress-showed a significant correlation between the low and high groups (r=.188, p=.043) (r=.201, p=.042). Conclusion: Paramedic students require education on how to cope with life stress. However, access to education is limited to people living in modern times. As a potential solution to this problem, observing videos on the Internet is recommended. Moreover, we suggest accessing Internet and smart phone applications for advertising/educational purposes.