• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.3
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• pp.167-172
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• 2014

Background: Propofol is the most commonly used anesthetic for sedation and target-controlled infusion (TCI) is useful for dental treatment. However, it is important to assess and maintain an adequate depth of sedation in patients with severe intellectual disabilities Therefore, in this study we aimed to evaluate the adequate propofol target concentration for dental treatment in severely intellectually disabled patients. Methods: We undertook retrospective review of the sedation records of severely intellectually disabled patients who underwent dental treatment under TCI propofol sedation from September 2011 to April 2012. We evaluated the initial target concentration, stabilized concentration of propofol and monitored vital signs, including BIS score using sedation records. Results: Total 20 patients (10 male and 10 female patients) were included in the study. Every participant was severely intellectually disabled. The mean sedation duration was $70{\pm}16$ (45-100) minutes. The initial propofol target concentration infusion amount was $2.7{\pm}0.45$ (2.0-3.0) mcg/ml. The propofol effect site concentration (Ce) was $2.6{\pm}0.7$ (1.0-4.0) mcg/ml. The average value of BIS was $52.6{\pm}13$ (28-81). During the treatment period, there were no severe complications. Conclusions: The average propofol Ce for deep sedation without any complications in intellectually disabled patients was 2.6 mcg/ml.

• 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 academy of Pediatric Dentistry
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• v.50 no.1
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• pp.75-88
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• 2023

The aim of this retrospective study was to evaluate the demographic characteristics of pediatric dental patients who underwent dental treatment under general anesthesia (DTGA) at the Seoul National University Dental Hospital from January 2011 through December 2020 and compare the patterns of repeated DTGA between dental patients with severe disabilities (DSD) and non-DSD (healthy or medically compromised patients without DSD). There were 1,857 DTGAs among 1,719 patients (mean age = 5.1 years; males = 59.3%; ASA 2 or above = 52.9%; DSD = 26.8%). Overall, 6.6% of patients underwent repeated DTGA, and the rate of repeated DTGA over a 10-year period was 7.4%. ASA 2 or above (p < 0.0001) and DSD (p < 0.0001) were more likely to undergo repeated DRGA compared to ASA 1 and non-DSD. At both GA1 and GA2, DSD received significantly more restorative treatment on permanent teeth than non-DSD (p = 0.002, p < 0.0001, respectively). There has been an increasing demand for DTGA in pediatric dentistry over the last 10 years. Regular check-ups and preventive oral health care are necessary for pediatric dental patients with severe disabilities to reduce the possibility of repeated DTGA.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.183-188
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• 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

• Journal of Korean Academy of Nursing
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• v.31 no.4
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• pp.656-668
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• 2001

Purpose: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. Method: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. Conclusion: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.

• Journal of Digital Convergence
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• v.18 no.6
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• pp.459-466
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• 2020

This study aimed to analyze characteristics and factors affecting of depression by households type of elderly with disabilities. Data were analyzed using chi-square test, logistic regression analyses according to the PSED. Data were 608 individuals. First, The one-person households group showed significantly female, non-capital, severe disorder, lower health status, lower economic level, higher help for daily life, higher experience of discrimination, lower satisfaction with relationship, lower participation in social activities. Second, Factors affecting depression included experience of discrimination, participation in social activities. Multi-person group included gender, occupied area, health status, economic level and one-person group were help for daily life. In order to reduce depression, it is necessary to reduce experience of discrimination, improve awareness of disability, health care, economic supports and so on. This study is meaningful in that it classifies households types. In the future, there is a need to longitudinal studies.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.125-132
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• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.

• Journal of Acupuncture Research
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• v.41
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• pp.149-159
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• 2024

Background: Police officers are an occupational group with a high risk of developing musculoskeletal, cardiovascular, and mental diseases because of the nature of their work. This study aimed to gain an understanding of job-related health risks by comparing overall health awareness, presence of physical and mental disabilities and their causes, medical use patterns, and quality of life of the general public through a survey. Methods: In this comparative study, police officer data were collected through a survey conducted from October 1, 2022, to November 15, 2022, and general public data from the 8th National Health and Nutrition Examination Survey of Korea were used for comparison. Results: Police officers' health perception of physical or mental disabilities was significantly more negative than that of the general public because of their work characteristics, patterns, and functions. In addition, police officers with disabilities had severe work and daily living limitations, and their awareness of their overall quality of life was low enough to warrant alarm. Despite their high rates of seeking treatment in medical institutions, continuous medical use was limited. Conclusion: More research on major diseases to which police officers are at risk of exposure is necessary to analyze risk factors and accumulate related data to systematize health management. In addition, Korean medicine treatment techniques with excellent disease prevention are recommended for the health management of police officers.

• The Journal of the Convergence on Culture Technology
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• v.10 no.4
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• pp.367-372
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• 2024

Although developmental disabilities account for a relatively low number of the total number of disabilities, they are generally classified as severe disabilities considering the degree of disability. If these developmental disorders are discovered early, adaptability and early treatment efficiency can be improved, but most parents do not detect any signs from their children or miss the right time for treatment. In this paper, we conducted development of the developmental disorder diagnosis algorithm that can recognize hand-flapping, one of the early unusual behaviors of developmental disorders, for parents and early childhood care workers who cannot recognize signs of early developmental disorders based on specific behavioral characteristics as a pilot study. It was confirmed that the recognition area and fingers were accurately recognized, and the number of hand flapping was accurately counted. It is expected that research on algorithms that can diagnose various behavioral patterns will continue to be conducted and expanded all through algorithms advancement and expansion of functional performance using big data.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.272-280
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• 2018

The purpose of this study was to analyze characters and determinant factors of the life satisfaction of the older adults with disabilities so as to provide suggestion for improving the quality of life. I used the data on 8th Panel Survey of Employment for the Disabled(PSED). The total number of respondents was 452, 126 respondents of one-person households and 326 respondents of multi-person households. The data was analyzed using SPSS Win 24.0 program and utilizing $x^2$test, ANOVA, logistic regression analysis. First, The characteristics of older adults with disabilities was man, married, mild disorder, physical external disorder, non-basis living security recipient, unemployment and the level of life satisfaction was 3.27. Second, The one-person households group showed female, non-married, severe disorder, lower acceptance of disability, lower health status, higher help daily living activity, higher discrimination experience, unemployment, lower income, basis living security recipient, lower position than multi-person group. Third, acceptance of disability, health status, social activity, religion were found to have a significant effect on the life satisfaction of one-person households. And acceptance of disability, health status, position were found to have a significant effect on the life satisfaction of multi-person households. Base on the results of this study, suggested for improving the quality of life of the older adults with disabilities.