• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Korean Journal of Adult Nursing
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• v.12 no.2
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• pp.234-244
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• 2000

It is widely recognized that manipulation of body position takes advantage of the influences of gravity for improving oxygenation. The study aims to determine the effects of positioning(supine, prone, right lateral decubitus and left lateral decubitus positions) applied to the mechanically ventilatory acute respiratory failure patients on arterial oxygen partial pressure($PaO_2$), alveolar arterial oxygen tension difference($AaDO_2$), mean aterial pressure, peak inspiratory pressure and plateau pressure. Thirty two acute respiratory failure patients admitted to the medical intensive care unit at Kangnam St. Mary's Hospital, The Catholic University of Korea from March 1997 to January 1998, were divided into three groups by radiographic evidence of unilateral or bilateral lung disease. In group 1 with dominant right lung disease were twelve subjects, group 2 with dominant left lung disease had eight subjects and group 3 had twelve subjects with bilateral lung disease. The variables were measured in 30 minutes after each position of supine, prone, good lung down lateral decubitus and sick lung down lateral decubitus position. The position order was done at random by Latin squre design. The results are as follows; 1) With group 1 patients, the $PaO_2$ in the left lateral decubitus and prone position were $126.8{\pm}30.8$ mmHg and $106.7{\pm}36.8$ mmHg, respectively(p=0.0001). 2) With group 2 patients, the $PaO_2$ in the prone and the right lateral decubitus position were $121.7{\pm}44.7$ mmHg and $118.5{\pm}31.7$ mmHg, respectively (p=0.0018). 3) With group 3 patients, the $PaO_2$ was $143.6{\pm}36.6$ mmHg in the prone position (p=0.0001). 4) With group 1 patients, the $AaDO_2$ in the left lateral decubitus and the right lateral decubitus position were $178.1{\pm}29.7$ mmHg and $233.1{\pm}24.4$ mmHg, respectively(p=0.0001). 5) With group 2 patients, the $AaDO_2$ in the prone and the left lateral decubitus postion were $184.0{\pm}39.5$ mmHg and $231.0{\pm}23.9$ mmHg, respectively(p=0.0019). 6) With group 3 patients, the $AaDO_2$ in the prone and the supine postion were $377.1{\pm}35.6$ mmHg and $435.7{\pm}13.1$ mmHg, respectively (p=0.0001). 7) There were no differences among the mean arterial pressure, peak inspiratory pressure and plateau pressure for each of the supine, prone, left lateral decubitus and right lateral decubitus position. The results suggest that oxygenation may improve in mechanically ventilatory patients with unilateral lung disease when the position is good lung dependent and prone, and patients with bilateral lung disease when the position is prone without any effects on the mean arterial pressure and airway pressure. It is suggested that body positions improve ventilation/perfusion matching and oxygenation need to be specified in patient care plans.