• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.1
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• pp.12-17
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• 2018

Objectives: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. Materials and Methods: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015. In total, 31 patients with complex factures requiring submental airway derivation were included. No complications such as bleeding, infection, vascular, glandular, or nervous lesions were presented in any of the patients. Results: The use of submental airway derivation is a simple, safe, and easy method to ensure airway management. Moreover, it allows an easier reconstruction. Conclusion: Based on these results, we concluded that, if the relevant steps are followed, the use of submental intubation in the treatment of patients with complex facial trauma is a safe and effective option.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.47-57
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• 2008

Purpose: Providing oral care is one of the most important nursing interventions in ICU. Good oral health prevents various complications including pneumonia and improves patients' well-being as well. The purpose of this study was to indentify the ICU nurses’awareness and performance on oral care. Methods: Using a convenient sampling, 170 ICU nurses from 5 university hospitals in two metropolitan cities were selected. Results: Of the 170 nurses in this study, 95.9% were aware of the importance of oral care. Subjects responded that providing oral care three times or more a day was appropriate to prevent ventilator associate pneumonia. 43.5% of the subjects acknowledged that they didn’t know what the most effective oral care solution was. In oral care performance, 61.8% of subjects provided oral care once a day for patients with intubation, and 74.7% used oral solutions without knowing the exact pharmacological effects of them. Conclusion: As the results of this study, most ICU nurses realized the importance on oral care for ICU patients, but the frequency of performance was low. To improve oral care performance in the ICU, structured education should be provided to ICU nurses and evidence based oral care protocols need to be developed.

• Journal of the Korean Society of Food Science and Nutrition
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• v.23 no.5
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• pp.725-730
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• 1994

This study was conducted to investigate the effect of dietary zinc (Zn) and/or cadmium (Cd) on hepatic microsomal and cytosol enzyme activities. Male Spraque-Dawley rats (110$\pm$10g ) received zinc (0, 30 and 300 ppm/) and Cd-treated groups were administered oral intubation with Cd chloride (5.0mg/kg of body weight 0 at the same time once a week. The effect of Cd on the activity of hepatic cytochromep-450 , xanthine oxidase(X. O) and superoxide dismutase (SOd) was studied in rats. Cd oral intubation resulted in a decrease in cytochrome P-450 content and SOD activity whereas a significant increase in the X.O. activity was observed was observed . Intake of excessive Zn led to an increased activity of microsomal alcohol dehydrogenase (ADH) , whereas Zn deficiency group led to a decreased group. The mechanism by which Zn induces the decreasing of Cd toxicity in rats, seems to rely on the protection of the enzyme systems P-450, ADH, aldehyde dehydrogenase (ALDH) and X.O. in the liver, possibly by forming non-toxic Cd metallothionein. These results indicate that Zn and Cd regulation might occur via inhibitory protein component of the $H_2O$$_2$ -generator system.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.3
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• pp.324-333
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• 2010

Purpose: The purpose of this study was to evaluate the effects of three different oral care treatments on the oral state of patients with intubation in intensive care units. Methods: The research design was a nonequivalent control group design with repeated measures. The patients were assigned a normal saline, chlorhexidine or toothbrushing group. Each group received its own oral care treatment for 5 minutes, twice a day and for 8 days. The oral assessment guide, hygiene performance index and pathogenic microorganisms. Data were collected from patients before the experiment, 4 days after, and 8 days after completion and were evaluated. Results: The chlorhexidine group and tooth brushing group showed significant improvement on the oral assessment guide and decrease in the hygiene performance index, compared to the normal saline group. Similarly, pathogenic microorganisms were significantly decreased in the chlorhexidine group and tooth brushing group, when compared to the normal saline group. Conclusions: Oral treatments with chlorhexidine and toothbrushing improve the oral health state of patients, therefore use of chlorhexidine and toothbrushing could be an effective nursing intervention for intubated patients in intensive care units.

• The Journal of the Korean dental association
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• v.11 no.1
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• pp.45-52
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• 1973

Ketamine HC1(Phencyclidine derivative) is a white, crystalline substance with melting point 259℃. It is soluble in water to a 20% clear, colorless solution. a 10% aqueous solution has a pH 3.5. The chemical structure is 2-(O-chlorophenyl)-2-(methylamino) cyclohexanone hydrochloride. It is a rapid acting, nonhypnotic, nonbarbiturate drug with a wide safety margin. The author used the anesthetic ketamine hydrochloride for oral surgery procedure in 16 patients(2 to 33 years). Anesthesia was achieved with a single intramuscular injection by introduction of manufacture. Result obtained as follows : 1. It was easily administered. 2. Onset time was rapid and duration was short. 3. The mild cardiac stimulation resulted in moderate increase in the blood pressure and pulse. 4. There was no significant respiratory depression. 5. The airway can be maintained without artificial support or endotracheal intubation. 6. All protective reflex maintained, which was important in oral surgery. 7. The best results were achieved in pediatric patients than adults.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.3
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• pp.185-191
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• 2016

Background: Failure to maintain a patent airway can result in brain damage or death. In patients with mandibular prognathism or retrognathism, intubation is generally thought to be difficult. We determined the degree of difficulty of airway management in patients with mandibular deformity using anatomic criteria to define and grade difficulty of endotracheal intubation with direct laryngoscopy. Methods: Measurements were performed on 133 patients with prognathism and 33 with retrognathism scheduled for corrective esthetic surgery. A case study was performed on 89 patients with a normal mandible as the control group. In all patients, mouth opening distance (MOD), mandibular depth (MD), mandibular length (ML), mouth opening angle (MOA), neck extension angle (EXT), neck flexion angle (FLX), thyromental distance (TMD), inter-notch distance (IND), thyromental area (TMA), Mallampati grade, and Cormack and Lehane grade were measured. Results: Cormack and Lehane grade I was observed in 84.2%, grade II in 15.0%, and grade III in 0.8% of mandibular prognathism cases; among retrognathism cases, 45.4% were grade I, 27.3% grade II, and 27.3% grade III; among controls, 65.2% were grade I, 26.9% were grade II, and 7.9% were grade III. MOD, MOA, ML, TMD, and TMA were greater in the prognathism group than in the control and retrognathism groups (P < 0.05). The measurements of ML were shorter in retrognathism than in the control and prognathism groups (P < 0.05). Conclusions: Laryngoscopic intubation was easier in patients with prognathism than in those with normal mandibles. However, in retrognathism, the laryngeal view grade was poor and the ML was an important factor.

• Journal of Korean Biological Nursing Science
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• v.17 no.2
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• pp.97-103
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• 2015

Purpose: The aim of the study was to identify effects of oral care protocol on bacterial floras of the oral cavity and oral health status of intubated patients in an intensive care unit. Methods: The participants were 60 intubated patients who were recruited from an intensive care unit of a university hospital from Dec. 28, 2010 to Mar. 25, 2011. The participants were randomly assigned into 3 groups of 20 patients according to the application time of oral care (1-minute oral care, 2-minute oral care, and 3-minute oral care groups). The numbers of bacterial flora colonies in the oral cavity was assessed before and after the oral care. Oral health status was assessed using a Korean version of the Oral Assessment Guide developed by Elier et al. originally. Results: The numbers of bacterial flora colonies were less after oral care than those before the care, but there was no significant differences among the 3 groups after the care. Oral health status was better after the oral care than it was before the care, but there was also no significant differences among the 3 groups. Conclusion: If well-trained nurses perform oral care for 1 minute using a chlorhexidine swab on intubated patients, the numbers of bacterial flora colonies will be reduced and healthy oral status will be maintained.

• Journal of the Korean Society of Food Science and Nutrition
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• v.23 no.4
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• pp.574-580
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• 1994

The effect of dietary zinc(Zn) levels on cadmium (Cd)-induced hepatotoxicity was studied in serum and liver of rats. Adult male Spraque-Dawley rats were fed on diets containing one of three levels of zinc carbonate(0, 56, $560\mu\textrm{g}/kg$ diet) and Cd-treated groups were administrated oral intubation with cadmium chloride 95.0 mg/kg of body weight) at the sametime once a week. Net weight gain (NWG), feed intake (FI) and feed effciiency ratio (FER) in Zn deficiency groups significantly decreased as compared to that of control and excessive groups. Cd oral intubation caused a decrease in NWG and FI but an increase in Zn deficiency group in FER. GSH-Px, GST and catalase activity showed significant decrease in Zn deficiency and Zn excessive group. LPO content in liver significantly increased in Zn deficiency group. Cd oral intubation increased the content of LPO in Zn deficiency group as compared to control. GSH content and GST activity of hepatic tissue significantly decreased in Zn deficiency and excessive group. The activity of AST and ALT in serum were markedly increased in Zn deficiency, Zn excessive and Cd-treated groups. LDH and ALP activities significantly increased in Cd-treated group while ALP activity decreased by Zn deficiency. It was observed that the livers of rats exposed to Cd and Zn excessive group showed a marked increase of hepatic enzyme as compare to only Cd-treated in rats.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.25-35
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• 2010

Purpose: The purpose of this pilot study was to investigate the effect of oral care using 0.1% chlorhexidine and tantum solution on oral status and incidence of oral pathogens among intubated ICU patients. Methods: The study subjects were 26 intubated patients of MICU in a university hospital. Oral care was provided with 0.1% chlorhexidine solution to the experimental group (n=12) and with tantum solution to the control group (n=14), 3 times a day for 6 days. After the intervention, the oral status of each subject was checked using structured method, and oral swab culture was done to count colonized bacterial pathogens. Results: The mean oral status score of experimental group was significantly higher than that of control group (U=42.50, p=.031). The mean incidence of oral pathogens in experimental group was smaller than that of control group, but the difference was not statistically significant. Conclusion: The oral care with 0.1% chlorhexidine solution is more effective than with tantum solution for improving oral status of intubated ICU patients. However, additional studies with larger sample size will be needed to figure out it's effects on the incidence of oral pathogens.

• Journal of Oral Medicine and Pain
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• v.42 no.2
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• pp.44-48
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• 2017

Chronic temporomandibular joint dislocation is defined as an acute dislocation that cannot be reduced or that recurs for more than one month. The management of dislocation depends on patient status and the duration of dislocation and ranges from conservative reduction to a surgical approach. In the present cases, a 64-year-old male was referred to our department for treatment of chronic dislocation for 6 weeks. The dislocation might be occurred by endotracheal intubation. A 70-year-old female was referred to our department with repeat right condyle dislocation after reduction of dislocation at a local clinic. When she visited for later treatment of new dentures, her condyle had been dislocated again for several weeks. In both cases, we tried to treat the dislocation with several manipulations, which were unsuccessful. Finally, chronic dislocation was successfully treated by surgical traction under general anesthesia without relapse. Surgical traction is a simple, effective option with the lowest morbidity of surgical procedures for chronic dislocation when conservative reduction is unsuccessful.