• 대한치과마취과학회지
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• 제14권2호
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• pp.115-117
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• 2014

Septic pulmonary embolism is a rare disease entity that consists of pulmonary infection and embolism predominantly arising from endocarditis and thrombophlebitis. We report a rare case of candidal septic pulmonary embolism secondary to odontogenic infection in a previously healthy and immunocompetent man, who had a submandibular abscess with dyspnea and fever. The patient was not responsive to prolonged broad spectrum antibiotics and surgical drainage, however, antifungal therapy was successful after Candida albicans was confirmed by his blood culture. Since proper identification and the resolution of the septic origin is as important as the diagnosis of septic pulmonary embolism, in a patient with odontogenic infection, who shows definite respiratory complications despite antimicrobial therapy with surgical drainage, various culture examinations should be adopted.

• 대한치과의사협회지
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• 제51권8호
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• pp.451-458
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• 2013

Human immunodeficiency virus is a retrovirus that causes acquired immunodeficiency syndrome. Acquired immunodeficiency syndrome is defined in terms of "either the occurrence of specific diseases in association with a HIV infection or a CD4 cell count below 200cells/ul" by centers for disease control and prevention(CDC). When performing the surgery of human immunodeficiency virus infected patients, several factors should be considered. First, standard precautions should be performed to prevent infection. It is safe to treat human immunodeficiency virus infected patients if we follow the standard precautions. Second, when making a surgical plan, surgeons have to take account of delayed bone healing and postsurgical infection. This case report presents a case of orthognathic surgery of human immunodeficiency virus infected patient.

• 한국응용과학기술학회지
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• 제35권3호
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• pp.587-594
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• 2018

본 연구의 목적은 치과종사자의 손씻기에 대한 건강신념과 손씻기 수행도 간의 관련성을 파악하여 평가하는 것이다. 본 연구는 치과의원, 치과대학병원에서 근무하는 140명의 치과종사자를 대상으로 구조화된 설문지를 사용하여 자가보고식으로 작성하도록 하였다. 모든 자료는 통계분석은 t검정, 일원분산 분석, Pearson 상관계수분석으로 통계처리 하였다. 손씻기 수행도는 손씻기에 대한 건강신념과 r=0.285로 양의 상관관계를 보였다(p<0.01). 치과의원, 치과대학병원에서 근무하는 치과종사자의 병원감염 예방을 실천하기 위해서는 감염관리 교육 시 지각된 민감성, 지각된 심각성, 지각된 유익성, 지각된 장애성, 수행을 위한 동기로 구성된 손씻기에 대한 건강신념을 고려하고, 지속적인 손씻기 교육을 시행한다면 치과종사자의 손씻기 수행도도 증가할 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권2호
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• pp.67-72
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• 2014

Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. Although NF of the face is rare, its mortality rate is nearly 30%. It usually originates from dental infection and can lead to involvement of the neck, mediastinum, and chest wall. Complications resulting from pre-existing systemic diseases can increase the mortality rate. Known complication factors for NF include diabetes, malnutrition, advanced age, peripheral vascular disease, renal failure, and obesity. Here, we report a case of NF originating from dental infection in an 88-year-old woman already diagnosed with hypertension, thoracic aortic aneurysm, and renal diseases. Such conditions limited adequate surgical and antibiotic treatment. However, interdisciplinary treatment involving multiple departments was implemented with good results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권4호
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• pp.195-198
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• 2014

Cavernous sinus thrombosis not only presents with constitutional symptoms including fever, pain and swelling but also with specific findings such as proptosis, chemosis, periorbital swelling, and cranial nerve palsies. It is known to occur secondary to the spread of paranasal sinus infections in the nose, ethmoidal and sphenoidal sinuses. However, paranasal sinus infection of dental origin is rare. The following is a case of cavernous sinus thrombosis due to the spread of an abscess in the buccal and pterygomandibular spaces via buccal mucosal laceration.

• International Journal of Oral Biology
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• 제35권1호
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• pp.7-12
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• 2010

The aims of this study were to investigate the nosocomial infection route of methicillin-resistant Staphylococcus aureus (MRSA) and explore preventative methods for this pathogen that involve blocking its dispersion. We cultured MRSA from nasal cavity swabs collected between June and July 2008 that we obtained from eight dental healthcare providers, 32 nurses and the sputum specimens of two patients from our hospital. In addition, we used VITEK 2 equipment to measure drug sensitivity, and we further performed biochemical testing and pulse-field gel electrophoresis (PFGE) to isolate MRSA colonies. The incidence of these bacteria on the nasal swabs was 25.0% from dental clinic healthcare providers, 13.6% from the internal medicine ward nurses and 30.0% from intensive care unit nurses. Moreover, MRSA was detectable in sputum specimens of ward patients. The antimicrobial agents resistance and partial PFGE types of MRSA showed a similar pattern. We suggest from these analyses that nasal cavity infection by MRSA could occur by cross contamination between healthcare providers and patients which underscores the importance of stringent MRSA management practices.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권3호
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• pp.103-106
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• 2018

Objectives: The goal of the study was to investigate the clinical effects of amoxicillin-clavulanic acid (500+125 mg) with metronidazole 400 mg administered three times daily (Group I) versus azithromycin 500 mg administered once daily and with metronidazole 400 mg three times daily (Group II) for the prevention of postoperative infection following mandibular third molar surgical removal. Materials and Methods: The study design was a single-center prospective study. Patients who reported to the Department of Oral and Maxillofacial Surgery between February 2015 and January 2017 for removal of mandibular third molar were screened, and 108 patients were chosen. One surgeon carried out all procedures. Patients were prescribed antibiotics until the two groups contained a similar number of cases. Results: Our data showed that Group II had fewer incidences of surgical site infection, but with no statistical significance. Conclusion: Although both treatments are used routinely after removal of the mandibular third molar, neither is significantly better than the other.

• Journal of Chest Surgery
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• 제33권8호
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• pp.688-692
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• 2000

Descending Necrotizing Mediastinitis(DNM) is a complication of oropharyngeal infections that can spread to the mediastinum. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. late diagnosis is the principal reason for the high mortality in DNM. An 18-year-old female admitted with Ludwig's angina from dental caries. Despite of combined antibiotics, dental extraction and drainge of submental abscess, infection spread to the cervical area. Chest computed tomogram revealed extension of the abscess to the pretracheal and periaortic space and development of bilateral pleural empyema. We performed bilateral cervical mediastinotomy and thoracotomy for drainage and debridement. Tracheostomy to secure the airway and postoperative pleural irrigation were performed. Postoperative course was uneventful and patient was discharged on the 40th postoperative day. It is important to perform chest CT scanning for early diagnosis of DNM when oropharyngeal infection spreads to the cervical area. Improved survival of patients with DNM implies early and radical surgical drainage and debridement via a cervical mediastinomy and thoracotomy.

• 대한치과의사협회지
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• 제52권4호
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• pp.192-202
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• 2014

Bisphosphonate(BP) significantly influence the hone remodeling process. Increasing number of patients with osteoporosis and metastatic bone disease need high dose or long term bisphosphonate therapy. Major adverse effect is jaw bone necrosis and now the bisphosphonate-related necrosis of the jaw(BRONJ) is the major concern of dental practitioner. This study intended to perform the review of the current understandings concerning the pathophysiology of BRONJ. Even though pathophysiological mechanism of BRONJ is not clearly elucidated but now suggested as largely two different concepts; so-called "inside-out" or "outside-in" theory. Inside-out theory emphasize the osteonecrosis of the jaw is the initial major event and subsequent infection and inflammation is the second event that accompanies bone exposure and death of overlying mucosa. However, in "outside-in" theory, infection or inflammation initiated by traumatized oral epithelium is the major event of BRONJ. Both theory would be partially explain BRONJ. Recent research reveals the immune modulating effect and influence of microcrack accumulation by BP. These findings and those of others might explain the missing part of outside-in theory.

• 치위생과학회지
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• 제13권3호
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• pp.254-263
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• 2013

본 연구는 국내 치과의료기관 감염관리 평가지표를 도출하고 타당성을 검증하고자 하는 연구로서 평가지표의 구성단계, 개발단계, 검증단계로 설계되었으며, 평가지표 구성단계에서 이론적 고찰과 모형의 적용, 평가지표의 개발단계에서 국내 치과병원 감염관리담당자를 대상으로 양적, 질적방법의 예비조사와 관련 전문가를 대상으로 설문조사와 면접조사가 실시되었으며 신뢰도, 안면타당도와 내용타당도검증을 실시하였고 전국의 치과병원 감염관리담당자 121명을 대상으로 감염관리 평가지표 항목에 대한 가중치 조사 및 현장 적용의 문제점을 확인하였다. 평가지표 검증 단계에서는 탐색적 요인분석과 경로분석을 통해 구성타당도를 확인하였다. 이상의 모든 통계적 처리는 PASW Statistics 18.0 프로그램과 AMOS 5.0 프로그램을 이용하였다. 연구의 결과로 국내 치과병원 감염관리 평가지표는 구조, 과정, 결과 영역이 수립되었으며 구조 영역에서 5개 평가요인에서 21개의 세부 평가지표가 도출되었고, 과정 영역에서 8개 평가요인에서 32개의 세부 평가지표가 도출되었으며, 결과 영역에서 1개 평가요인에서 5개의 세부 평가지표가 도출되어, 각 영역에서 총 14개의 평가요인과 58개의 세부 평가지표가 도출되었다. 또한 상관성이 성립되는 8개 평가요인에 대한 경로분석 결과 '표준주의지침($x_1$)', '감염관리지원체계($x_2$)', '내외부적 특성($x_3$)'은 다른 변수들에 영향을 주는 외생관측변수이고 '표준감염관리($y_1$)', '기구 장비관리, 손씻기($y_2$)', '환경감염관리($y_3$)', '개인보호장구($y_4$)', '세탁물 및 폐기물관리($y_5$)' 등은 다른 변수들로부터 영향을 받는 내생관측변수로 작용함을 알 수 있었다. 본 연구에서는 우리나라 치과의료기관 실정에 맞는 감염관리 표준을 위해 평가지표를 개발하고자 하였으며 개발된 치과의료기관 감염관리 평가지표를 통해 국내 치과의료기관 감염관리 체계 활성화 및 감염관리 우선순위 결정에 기여하고자 한다. 향후 치과의료기관 감염관리의 질적 제고를 위하여 감염관리 평가제도 및 인증제도 활성화를 제안하며 향후 지속적인 연구와 관심이 필요하다.