• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.74-77
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• 2015

Objectives: Transpositioning of the inferior alveolar nerve to prevent injury in lower jaw has been advocated for orthognathic, pre-prosthetic and for implant placement procedures. However, the concept of infra-orbital nerve repositioning in cases of mid-face fractures remains unexplored. The infraorbital nerve may be involved in trauma to the zygomatic complex which often results in sensory disturbance of the area innervated by it. Ten patients with infraorbital nerve entrapment were treated in similar way at our maxillofacial surgery centre. Materials and Methods: In this article we are reporting three cases of zygomatico-maxillary complex fracture in which intra-operative repositioning of infra-orbital nerve into the orbital floor was done. This was done to release the nerve from fractured segments and to reduce the postoperative neural complications, to gain better access to fracture site and ease in plate fixation. This procedure also decompresses the nerve which releases it off the soft tissue entrapment caused due to trauma and the organized clot at the fractured site. Results: There was no evidence of sensory disturbance during their three month follow-up in any of the patient. Conclusion: Infraorbital nerve transposition is very effective in preventing paresthesia in patients which fracture line involving the infraorbital nerve.

• Biomolecules & Therapeutics
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• v.25 no.3
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• pp.259-265
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• 2017

This study aimed to investigate the analgesic effect of substance P (SP) in an animal model of neuropathic pain. An experimental model of neuropathic pain, the chronic constriction injury (CCI) model, was established using ICR mice. An intravenous (i.v.) injection of SP (1 nmole/kg) was administered to the mice to examine the analgesic effects of systemic SP on neuropathic pain. Behavioral testing and immunostaining was performed following treatment of the CCI model with SP. SP attenuated mechanical allodynia in a time-dependent manner, beginning at 1 h following administration, peaking at 1 day post-injection, and decaying by 3 days post-injection. The second injection of SP also increased the threshold of mechanical allodynia, with the effects peaking on day 1 and decaying by day 3. A reduction in phospho-ERK and glial fibrillary acidic protein (GFAP) accompanied the attenuation of mechanical allodynia. We have shown for the first time that i.v. administration of substance P attenuated mechanical allodynia in the maintenance phase of neuropathic pain using von Frey's test, and simultaneously reduced levels of phospho-ERK and GFAP, which are representative biochemical markers of neuropathic pain. Importantly, glial cells in the dorsal horn of the spinal cord (L4-L5) of SP-treated CCI mice, expressed the anti-inflammatory cytokine, IL-10, which was not seen in vehicle saline-treated mice. Thus, i.v. administration of substance P may be beneficial for improving the treatment of patients with neuropathic pain, since it decreases the activity of nociceptive factors and increases the expression of anti-nociceptive factors.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.9-17
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• 2023

Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.15-21
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• 2023

Purpose: Dental avulsion injuries have a poor prognosis that largely depends on the immediate steps taken to manage the avulsed tooth. A lack of knowledge about the initial management can lead to tooth loss, with further adverse implications for esthetics, phonetics, and overall growth and function. Hence, the present study aimed to assess parents' knowledge regarding dental avulsion and the variables associated with their knowledge of avulsion injuries. Methods: A series of closed-ended questions on parents' knowledge regarding avulsion, such as immediate management, storage media, handling, and urgency of visiting the dentist, was asked. Univariate associations between the outcomes were assessed using the Pearson chi-square test. The chisquare goodness-of-fit test was used to check whether the sample data were representative of the population. Results: In total, 211 mothers and 149 fathers were included, of whom 46.7% had experienced dental trauma during their own childhood. Sixty-one percent of mothers believed that they knew everything necessary about tooth avulsion and its management. A significant number of participants who thought that they had a good level of knowledge about avulsion chose water, tissue, or paper wrap to transport the tooth, and preferred tap water, alcohol, or antiseptic to clean the avulsed tooth. Conclusions: Both mothers and fathers had poor knowledge about tooth avulsion, indicating that there is an immediate need for educational programs focusing on this issue. Since a substantial proportion of participants believed incorrect information, it is vital to disseminate accurate information.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.2
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• pp.81-90
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• 2024

Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.13.1-13.7
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• 2015

Background: This study evaluated Somatosensory evoked potentials (SEP), Quantitative sensory testing (QST), and thermography as diagnostic methods for nerve injury. Methods: From 2006 through 2011, 17 patients (mean age: 50.1 years) from ${\bigcirc}{\bigcirc}{\bigcirc}{\bigcirc}$ Hospital who sought care for altered sensation after dental implant treatment were identified. The mean time of objective assessment was 15.2 months after onset. Results: SEP of Inferior alveolar nerve(IAN) was $15.87{\pm}0.87ms$ on the normal side and $16.18{\pm}0.73ms$ on the abnormal side. There was delayed N20 latency on the abnormal side, but the difference was not statistically significant. In QST, the abnormal side showed significantly higher scores of the current perception threshold at 2 KHz, 250 Hz, and 5 Hz. The absolute temperature difference was $0.55^{\circ}C$ without statistically significance. Conclusion: These results indicate that QST is valuable as an objective method for assessment of nerve injury.

• Korean Journal of Occupational Health Nursing
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• v.28 no.2
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• pp.75-82
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• 2019

Purpose: This study aimed to determine the influence of injury and/or injured area classification on depression in patients with industrial injuries. Methods: The participants comprised438 patients who consented to participate and completed self-reported questionnaires. Data were analyzed using SPSS/WIN version 22.0 for descriptive statistics, $x^2$ test, fisher's exact test, ANOVA, and post-hoc $Scheff{\acute{e}}$ test. A stepwise multiple regression analysis was used to identify factors influencing depression. Results: The results indicated that the effect of disease classification and injured areas on depression were significantly different in patients with industrial injuries. The results further showed that severe depression was significantly higher in cardiovascular patients and patients with an injured area of the head and waist. The most powerful predictor was age (50~59 years), return to work (reemployment), disease classification (cardiovascular), and injured area (head, including vascular disease). Conclusion: This study showed that the most influential variable of depression in patients with industrial injuries were cardiovascular issues, injury areas of the head and waist, being aged 50~59 years, and reemployment. To reduce depression in these patients, it is important to develop and implement a psychiatric rehabilitation program that helps patients to formulate a concrete plan and goal for recovery, enabling patients to actively engage in their rehabilitation.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.454-460
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• 2007

Traumatic dental injuries in childhood and adolescent occurred more frequently than in adult. The time between the accident and the treatment is one of the most critical factors to prognosis, and because of the limited time available to examine and treat patients with traumatic dental injuries, if not treat appropriately, the result would be critical for the patient. In the previous studies, the prevalence and incidence of traumatic injuries were the most frequent at the age of 8 to 10 years, the majority of dental injuries involve the anterior teeth, especially the maxillary incisors, and males were more prevalent than females in an approximated proportion of 2:1. As the mean age of complete root formation is 10 years old, the maxillary permanent incisor involved in the most affected age group is usually immature, and the possibility of pulpal healing through excellent revascularization exists, more positive prognosis for pulp vitality would be expected. These are treatment cases of the immature maxillary permanent central incisor involved in the traumatic injury, and reports for progress and results of preserving the pulp vitality through the conservative treatment instead of the conventional endodontic root therapy.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.2
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• pp.101-106
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• 2014

Background: Remifentanil, an ultra-short-acting mu-opioid receptor agonist, is unique from other opioids because of its esterase-based metabolism, minimal accumulation, and very rapid onset and offset of clinical action. Remifentanil can prevent the inflammatory response and can suppress inducible nitric oxide synthase expression in a septic mouse model. However, the effects of remifentanil on human keratinocyte and autophagy have yet to be fully elucidated during hypoxia-reoxygenation. Here we investigated whether remifentanil confers protective effect against hypoxia-reoxygenation in human keratinocyte and, if so, whether autophagy mediates this effect. Methods: The human keratinocytes were cultured under 1% oxygen tension. The cells were gassed with 94% $N_2$, and 5% $CO_2$ and incubated for 24 h at $37^{\circ}C$. To determine whether the administration of affects human keratinocytes hypoxia-reoxygenation injury, cells were then exposed to various concentrations of remifentanil (0.01, 0.1, 0.5 and 1 ng/ml) for 2 h. After remifentanil treatment, to simulate reoxygenation and recovery, the cells were reoxygenated for 12 h at $37^{\circ}C$. Control group did not receive remifentanil treatment. Normoxia group did not receive hypoxia and remifentanil treatment for 36 h. 3-MA group was treated 3-methyladenine (3-MA) for 1h before remifentanil treatment. Cell viability was measured using a quantitative colorimetric assay with MTT, showing the mitochondrial activity of living cells. Cells were stained with fluorescence and analyzed with Western blot analysis to find out any relations with activation of autophagy. Results: Prominent accumulation of autophagic specific staining MDC was observed around the nuclei in RPT group HaCaT cells. Similarly, AO staining, red fluorescent spots appeared in RPT group HaCaT cells, while the Normoxia, control and 3-MA groups showed mainly green cytoplasmic fluorescence. We here examined activation of autophagy related protein under H/R-induced cells by Western blotting analysis. Atg5, Beclin-1, LC3-II (microtubule-associated protein 1 light chain 3 form II) and p62 was elevated in RPT group cells. But they were decreased when autophagy was suppressed by 3-MA (Fig. 5). Conclusions: Although the findings of this study are limited to an in vitro interpretation, we suggest that remifentanil may have a beneficial effect in the recovery of wound from hypoxia-reoxygenation injury.

• Applied Microscopy
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• v.32 no.3
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• pp.275-284
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• 2002

Granular gland regeneration in the toad after dorsal skin wound histologically was examined using scanning and transmission electron microscopy. After cutaneous wounds were induced by excision, animals were maintained in special cages for up to 20 days. In transmission electron microscopy (TEM), newly formed granular gland, though poorly developed, was seen on 4 day after injury. Epithelial cells moved toward apical region of newly formed gland. The cells had smooth surface and were not connected to other cells by desmosomes. Mitochondria rich cell (MRC) possessing long cytoplasmic processes formed a gland cavity and hemidesmosomes were found under the cell processes. Basal cavity of newly formed gland consisted of MRC, pro-granular producing cells (pGPC), and granular producing cell (GPC). Moreover it was observed that xanthophores moved to the base of the epithelial tissue on 10 day after the injury. These cells contained numerous pterinosomes and carotenoid vesicles. Immature pterinosomes were large and carotenoid vesicles were moderately electron dense. On 13 day after the injury, xanthophores contained abundant carotinoid vesicles and lammelated pterinosomes. Iridophores were also observed adjacent the developing xanthophores on 16 day post-injury. These observations indicated that regeneration of granular gland from glandular precursor cells during wound healing and subsequent expansion of the glandular cells might be dependent on maturation and proliferation of these newly formed cells.