• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.145-151
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• 2014

The goal of this study was to describe dental consultation of pediatric inpatients to the department of pediatric dentistry at Yonsei University Severance Hospital. 391 dental consultations at Yonsei University Severance Hospital referred to pediatric dentistry in the year 2012 were included in this study. Consultations were categorized according to patients' gender, age, chief complaint, referred department and diagnosis. 288 patients (166 males and 122 females) with an average age of 5.9 were referred to the Department of Pediatric Dentistry. 129 cases (33.1%) from Department of Rehabilitation Medicine, 80 cases (20.5%) from Pediatric Hematology- Oncology, 51 cases (13.0%) from Pediatric Cardiology, and 44 cases (11.3%) from Pediatric Neurology. Chief complaints were ranked from oral examination (39.7%), dental caries (14.0%), pre-operative evaluation (12.8%) and others (33.5%); including oral pain, trauma, tooth mobility, orthodontic treatment, self-injury, fabrication of obturator and etc. Dental consultations should be encouraged as dental care and treatment could affect the control of systemic diseases of admitted patients. Pediatric inpatients have been referred to pediatric dentistry for not only comprehensive oral exam but also various chief complaints. The most frequent dental diagnosis made and treatment performed were dental caries and non-invasive/preventive care respectively.

• Journal of Oral Medicine and Pain
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• v.24 no.1
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• pp.9-24
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• 1999

Pumping into the upper joint cavity of the TMJ was done on patients who had reducible disc displacement with pain. This article discusses the change in TMJ sounds before and after the Pumping treatment. 20subjects(mean age of $32.1{\pm}10.2yr$)were selected among those who visited the department of Oral Medicine of Yonsei University for the treatment of craniomandibular dysfunctions. Through a thorough history taking, clinical exam and X-ray taking these subjects were diagnosed as reducible disc displacement patients, and they were subdivided into two groups as acute and chronic according to the time the TMJ sound was made. Sonopak was used to measure the TMJ sound before, right after and one-week after the Pumping treatment. VAS was used to measure the degree of subjective TMJ complaints(sounds and pain) before and one-week after the Pumping treatment. Vibration related items included total integral, high integral, low integral, ratio of high integral to low integral, peak amplitude, peak frequency and median frquency. 1. It was not statistically significant between the acute and chronic groups before the treatment. However, total integral, high integral, low integral, peak amplitude, peak frequency, median frequency showed to be greater in the chronic group. 2. In all the subjects, just after the Pumping treatment was done, total integral, high and low integral, peak amplitude and peak frequency significantly decreased (p<0.05). Even after one week, low integral, peak frequency and median frequency significantly decreased (p<0,05), and the TMJ sound diminished accordingly. 3. Comparing the two groups(before and right after the Pumping treatment), there was the following difference ; in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05). In the chronic group, total integral, high integral, low integral, ratio, peak amplitude and peak frequency significantly decreased(p<0,05). It was not statistically significant between the acute and chronic group. 4. Comparing the two groups(right after and one week after the Pumping treatment), there was the following difference : in the acute group, high integral, high amplitude, high frequency and median frequency significantly decreased(p<0.05), In the chronic group, low integral significantly decreased(p<0.05). However, although it was not statistically significant, after one week, there was an increase in total integral, ratio, peak amplitude and peak frequency compared to right after the treatment group. 5. In the VAS of before and one week after the Pumping treatment of the TMJ pain and sound, the TMJ pain significantly decreased(p<0.05) in both the acute and chronic group. However, it was not statistically significant between the two groups. There was a statistically significant decrease(p<0.05) in the TMJ sound in the acute group after one week of Pumping treatment, but no change was notable in the chronic group and it was not statistically significant between the two groups. From the above results, we can conclude that Pumping into the upper joint cavity of patients having reducible disc displacement is effective in reducing clicking and pain. Therefore, it can be applied in diverse clinical fields.

• Imaging Science in Dentistry
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• v.47 no.1
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• pp.17-24
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• 2017

Purpose: The purpose of this study was to assess the accuracy, sensitivity, and specificity of the diagnosis of incipient furcation involvement with periapical radiography (PR) and 2 cone-beam computed tomography (CBCT) imaging protocols, and to test metal artifact interference. Materials and Methods: Mandibular second molars in 10 macerated pig mandibles were divided into those that showed no furcation involvement and those with lesions in the furcation area. Exams using PR and 2 different CBCT imaging protocols were performed with and without a metallic post. Each image was analyzed twice by 2 observers who rated the absence or presence of furcation involvement according to a 5-point scale. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy, sensitivity, and specificity of the observations. Results: The accuracy of the CBCT imaging protocols ranged from 67.5% to 82.5% in the images obtained with a metallic post and from 72.5% to 80% in those without a metallic post. The accuracy of PR ranged from 37.5% to 55% in the images with a metallic post and from 42.5% to 62.5% in those without a metallic post. The area under the ROC curve values for the CBCT imaging protocols ranged from 0.813 to 0.802, and for PR ranged from 0.503 to 0.448. Conclusion: Both CBCT imaging protocols showed higher accuracy, sensitivity, and specificity than PR in the detection of incipient furcation involvement. Based on these results, CBCT may be considered a reliable tool for detecting incipient furcation involvement following a clinical periodontal exam, even in the presence of a metallic post.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.105-109
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• 2012

The gag reflex is a physiological reaction, but, an exaggerated gag reflex can be a severe limitation not only to treat dental caries but also to do oral exam. Procedures such as surface anesthesia of the palate and pharyngeral area, sedation, or general anesthesia can be options as behavioral management. But, there are no golden rule for the sever gag reflex patients. We present a case report of propofol intravenous sedation using TCI pump for simple dental treatment. A 44-year-old man, who had past history of general anesthesia for dental treatment because of severe gag reflex, was scheduled intravenous sedation for simple dental treatment. After 8 hour fasting he entered the clinic for persons with disabilities. We explained about intravenous deep sedation and got informed consent. First, we kept intravenous catheter (22G) in the arm and started monitoring ECG, non-invasive blood pressure, pulse oximetry and end-tidal $CO_2$ through nasal cannula. We started propofol infusion with TCI pump at the target concentration of 3 mcg/ml. The patient became sedated, but he showed involuntary movement during dental treatment, so we increased the target concentration to 4 mcg/ml. We finished the dental treatment without complications during 30 min. And after 40 min recovery room stay he was discharged without any complications.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.11 no.1
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.194-197
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• 2012

Three dogs were presented with a history of dyspnea and cough. Physical examination, blood analysis, bronchoalveolar lavage and radiography of three dogs were evaluated. And additionally, computed tomography and lung biopsy were performed on one dog. They showed normal laboratory examination results. The radiographic findings noted alveolar and bronchointerstitial infiltration with bronchiectasis. For one dog, nodules scattered throughout both lung fields on survey radiographs were confused with pulmonary neoplasia, so CT scan was used to rule out neoplasia. Bronchoalveolar lavage revealed abnormally high levels of eosinophils in all dogs. On histopatholgic exam, eosinophilic bronchiolitis and eosinophilic and histiocytic alveolitis were confirmed. Consequently, all dogs were diagnosed as eosinophilic bronchopneumopathy. Symptoms regressed dramtically within a few days after treatment with oral corticosteroids. Radiographs and CT scan are useful for diagnosis and prognosis of eosinophilic bronchopneumopathy.

• Journal of Gifted/Talented Education
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• v.16 no.1
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• pp.43-60
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• 2006

This study mainly intended to investigate the relation between scientific inquiry and several entrance exam results of the gifted in earth science gifted program. The scientific inquiry was tested with their experiment designs. Entrance exams included achievement scores, creativity scores, problem solving, and oral test of high ability students. Student entrance scores were used to judge the level of students' competency in science. Recently students' ability of 'doing science' as measured by their designing experiments has been highly appreciated as a criteria of scientifically gifted students. One of the well known tests was Diet Cola Test developed by Fowler(1990). We used it as a test to figure out students' experiment design ability. We selected 22 gifted students in earth science. We compared their entrance test scores and Diet Cola Test results. Based on the comparison results we proposed several guideline of science education program for high ability students.

• Korean Medical Education Review
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• v.23 no.3
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• pp.185-193
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• 2021

Students must be familiar with clinical skills before starting clinical practice to ensure patients' safety and enable efficient learning. However, performance is mainly tested in the third or fourth years of medical school, and studies using the validity framework have not been reported in Korea. We analyzed the validity of a performance test conducted among second-year students classified into content, response process, internal structure, relationships with other variables, and consequences according to Messick's framework. As results of the analysis, content validity was secured by developing cases according to a pre-determined blueprint. The quality of the response process was controlled by training and calibrating raters. The internal structure showed that (1) reliability by generalizability theory was acceptable (coefficients of 0.724 and 0.786, respectively, for day 1 and day 2), and (2) the relevant domains had proper correlations, while the clinical performance examination (CPX) and objective structured clinical examination (OSCE) showed weaker relationships. OSCE/CPX scores were correlated with other variables, especially grade point average and oral structured exam scores. The consequences of this assessment were (1) making students learn clinical skills and study themselves, while causing too much stress for students due to lack of motivation; (2) reminding educators of the need to apply practical teaching methods and to give feedback on the test results; and (3) providing an opportunity for faculty to consider developing support programs. It is necessary to develop the blueprint more precisely according to students' level and to verify the validity of the response process with statistical methods.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.80-85
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• 2017

Angelman syndrome is a rare disorder caused by deletion or inactivation of genes on the maternally inherited chromosome 15. This neurodevelopmental disorder is characterized by developmental and intellectual delay, speech impairment, sleep disturbance, seizures, motor dysfunction, and frequent laughing or smiling. Orofacial characteristics include a prominent mandible, large mouth, prominent cheeks, a tendency to rest the tongue between the dental arches, excessive drooling, and excessive chewing behavior. Patients with this syndrome usually require general anesthesia even in a simple operation, because of risk of perioperative seizure during dental procedure. This is a case report about dental treatment of a 3-year-old female patient with Angelman syndrome under general anesthesia. This case suggests that the dental treatment under general anesthesia can be considered a safe component for the uncooperative, delayed developmental patients with underlying disease. Also, periodic dental exam appointment should be made to provide the patients with preventive treatments and to make them remain familiar with the dental environment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.293-300
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• 2011

Purpose: Substance P is a well known neurotransmitter and has been known to mediate pain. Recently, it has been unveiled that substance P is involved in the recruitment of mesenchymal stem cells to wound sites. The purpose of this study was to exam bone formation when a combination of substance P and silk fibroin was used in a bone defect model. Methods: Twenty rabbits were used and 40 calvarial defects were formed. They were divided as 4 groups (unfilled control, silk only, silk+$10{\mu}g$/ml substance P; Sub10, and silk+$100{\mu}g$/ml substance P; Sub100). All animals were humanely sacrificed 4 or 8 weeks after grafting. The specimens were analyzed by micro-computerized tomography and histological analysis. Results: When compared to the unfilled control to silk only group, there was significant difference in bone mineral density (BMD) and the attenuation coefficient (AC) at 4 weeks ($p$=0.037 and 0.038, respectively). When compared Sub10 group to Sub100 group, there was significant difference in BMD and AC at 8 weeks ($p$=0.004 for all). Residual graft amounts were $52.1{\pm}15.8$%, $15.2{\pm}9.2$% and $9.0{\pm}3.3$% for silk only, Sub10, and Sub100 groups, respectively. When comparing the residual graft amount of silk only to sub10 or sub100, the differences were statistically significant ($p$ <0.001). Conclusion: The silk fibroin scaffold showed higher BMD and AC than the unfilled control. The combination graft with substance P and silk fibroin scaffold showed a faster graft degradation than with a silk fibroin scaffold only.