The Journal of Korea Assosiation for Disability and Oral Health
/
v.13
no.2
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pp.114-118
/
2017
Sedation or general anesthesia is often required to offer dental treatment to patients with special needs. However, patients with ASA classification of III or higher are not indicated for moderate sedation and might be exposed to danger when treated at outpatient dental clinic. For this reason, it is recommended to treat those patients under general anesthesia. The dental team can supervise and monitor the whole procedures during treatment with an appropriately equipped facility. This case report describes the dental treatment of a 7-year-old girl with multiple disabilities. Preoperative evaluation including medical consultation was carried out thoroughly and dental treatment was performed under general anesthesia safely.
Seo, Kwang-Suk;Chang, Ju-Hea;Shin, Teo-Jeon;Kim, Hyun-Jeong
The Journal of Korea Assosiation for Disability and Oral Health
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v.5
no.1
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pp.18-22
/
2009
A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.
The purpose of this study is to develop cognitive behavioral therapy(CBT) to improve the parenting efficacy of married immigrant women, and verify its effectiveness. In the CBT of this study, behavioral technique was added to cognitive reconstruction based on cultural context in order to improve parenting efficacy. The study selected 28 married immigrant women, and randomly divided them into a CBT group(10), a general treatment group(8) and a control group(10). The CBT and the general treatment programs consisted of 10 sessions, approximately 2 hours in duration. The results of the study were as follows. 1) The level of parenting efficacy was improved significantly in the CBT and the general treatment group. 2) The level of negative automatic thoughts and dysfunctional parenting thoughts was significantly decreased only in the CBT group. 3) In the CBT and the general treatment group, the level of parenting stress and acculturative stress was decreased while the level of psychological well-being improved. On the other hand, the level of parent-adolescent communication was improved significantly only in the CBT group. 4) In comparison with the general treatment group, the CBT group showed higher parenting efficacy and lower automatic thoughts and dysfunctional parenting thoughts. This study has significance in its attempt to develop a parent training program to improve the parenting efficacy of married immigrant women by integrating behavioral modification and communication skills training focused on cognitive reconstruction of parenting-related negative thoughts and beliefs in application of the CBT paradigm.
The present study aims to investigate the impact of hydrogen-rich water on the lactic acid level in metformin-treated diabetic rats under hypoxia. Thirty Sprague-Dawley rats were randomly divided into five groups, including normal diet group, and diabetes model (DM) group, DM + metformin treatment (DMM) group, DMM + hypoxia treatment (DMMH) group and DMMH + hydrogen-rich water (DMMHR) group. We found that the levels of lactic acid, pyruvate and lactate dehydrogenase were significantly lower in the blood of DMMHR group than DMMH group. Superoxide dismutase and glutathione levels in liver and heart were significantly higher in DMMH group after hydrogen-rich water treatment, while malondialdehyde and oxidized glutathione levels were decreased in DMMHR group when compared with DMMH group, which indicates that hydrogen-rich water could reduce oxidative stress. qPCR analysis demonstrated that that pro-apoptotic genes Bax/Caspase-3 were upregulated in DM group and metformin treatment suppressed their upregulation (DMM group). However, hypoxic condition reversed the effect of metformin on apoptotic gene expression, and hydrogen-rich water showed little effect on these genes under hypoxia. HE staining showed that hydrogen-rich water prevented myocardial fiber damages under hypoxia. In summary, we conclude that hydrogen-rich water could prevent lactate accumulation and reduce oxidant stress in diabetic rat model to prevent hypoxia-induced damages. It could be served as a potential agent for diabetes patients with metformin treatment to prevent lactic acidosis and reduce myocardial damages under hypoxic conditions.
Park, Chan-Hee;Lee, Jong-Hyung;Lee, Han-Gil;Kim, Ji-Hun
The Journal of Korea Assosiation for Disability and Oral Health
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v.14
no.2
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pp.71-77
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2018
This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.
Purpose: A phase II study was conducted to evaluate the safety and efficacy of preoperative, intra-arterial perfusion of epirubicin, etoposide, and oxaliplatin combined with oral chemotherapy S-1 (SEEOX) for the treatment of type 4 gastric cancer. Materials and Methods: A single-center, single-arm phase II trial was conducted on 36 patients with histologically proven type 4 gastric cancer without distant peritoneal or organ metastasis. Patients received 3, 21-day courses of SEEOX preoperative chemotherapy. The primary endpoint was overall survival (OS) and the secondary outcomes assessed were chemotherapeutic response, radical resection rate, pathological regression, toxicities, postoperative morbidity, and mortality. Results: All patients were at an advanced stage of cancer (stage III or IV) and completed the entire course of treatment. Based on changes in tumor volume and peritoneal metastasis, the objective response rate was 55.6% (20/36; 95% confidence interval [CI], 38.5%-72.6%) and the disease control rate was 69.4% (25/36; 95% CI, 53.6%-85.3%). The radical resection rate was 75% (27/36; 95% CI, 60.1%-89.9%) and the proportion of R0 resections was 66.7% (21/36; 95% CI, 50.5%-82.8%). The pathological response rate was 33.3%, of which 13.9% showed complete pathological regression. The median survival was 27.1 months (95% CI, 22.24-31.97 months), and the 2-year OS was 48.5% (95% CI, 30.86%-66.1%). Conclusions: Preoperative SEEOX is a safe and effective treatment for type 4 gastric cancer. Based on these preliminary data, a phase III study will be conducted to confirm the superiority of this regimen over standard treatment.
Jung, Sung Tae;Ha, Chul Min;Lee, Hyung Ju;Jung, Young Yun
Journal of the Korean Burn Society
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v.23
no.2
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pp.42-53
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2020
Purpose: It is important to consider both clinical factors and epidemiological factors in treating burn patients in emergency rooms. However, many emergency medical staffs happen to miss their chances of treating burns based on these considerations. This study is designed to find a better treatment for burn patients in emergency rooms along this approach. Methods: This study was conducted based on the data of the burn patients visiting the emergency room of a single general hospital from January 2015 to December 2019. The epidemiological and clinical factors were extracted out of the data, then the relationship between the prognosis and these factors were analyzed. Results: Most of burn accidents occurred at home, and were caused by hot water, soup, drinks, oil, etc. Especially, flame burns showed high hospitalization rate, surgical rate and mortality. In addition, their prognosis was poor when the affected area included facial, limb and perineal areas etc., or any inhalation burn co-existed. Also, the hospitalization rate and period increased when the treatment time was delayed or the pre-treatment was taken. There was a strong relationship between prognosis and the period of follow-up when patients were admitted during the period. Conclusion: It is difficult for medical staffs to evaluate prognosis of burns in emergency rooms due to progressive damages. Precise treatment and disposition are essential for patients' good prognosis. Therefore, medical staffs should establish treatment plans by identifying the patient's epidemiological and clinical factors, rather than giving prescriptions based on fragmentary and superficial symptoms.
Kim, Kwang-Hyuk;Kim, So-Hee;Rhee, Sook-Hee;Park, Kun-Young
Preventive Nutrition and Food Science
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v.3
no.3
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pp.282-286
/
1998
To determine the immune effect of kimchi extracts in mice, 0.5mg/day of the extracts from kimchis, which were prepared with conventionally (general kimchi)and organically(organic kimchi) cultivated ingredients, were treated orally to male BALB/c mice. Following 1, 3 and 5 weeks of treatment , the Interleukin-2(IL-2) production in the presence (con-A-stimulated )or the absence(spontaneous)of con A 95 $\mu\textrm{g}$/ml) and the natural killer cell (NK) activity of the splenocytes were measured. The IL-2 production in most of treatments with methanol extract from general kimchi were significantly higher than those of control(p<0.05).And at the 3 weeks of treatment, the spontaneous or con A-stimulated IL-2 productions from splenocytes of mice treated with it increased more than those of control group, by 2.8 and 2.2 times, respectively. However, the longer the treatment with methanol extracts from organic kimchi showed the higher the enhancing effect on the IL-2 production. The spontaneous or con A-stimulatdIL-2 productions form splenocytes of mice treated with dicholoromethyane fraction from general kimchi also increased at 5 weeks of treatment compared to those of control group, by 2.7 and 2.5 times, respectively. The natural killer cell activity of splenocytes from mice treated with methano lextracts from general kimchi for 1 ~5 weeks significantly higher than that of control goup (p<0.01). The effect of methano extracts from general kimchi was the highest at 3 weeks of treatment, as same as in the IL-2 production. The enhancing effect of methano extracts from organic kimchi on the NK cell activity was the highest at 5 weeks of treatment . The NK cell activity of splenocytes from mice treated with dichloromethane fraction from general kimchi for 5 weeks was significantly higher than those in control and 3 weeks of treatment. These results showed that the effects of kimchi extracts on the IL-2 production and the NK cell activity in mice were profound in long term of treatment (3 and 5 weeks than 1 week) . We suggest that kimchi extracts might have an immune effect in part due to its enhancing action on the IL-2 production and the NK cell activity.
The Journal of Korea Assosiation for Disability and Oral Health
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v.3
no.1
/
pp.6-10
/
2007
Many disabled patients need extensive dental treatment because they have much difficulty in maintaining their oral hygiene. However, because they are not cooperative and not manageable, they require physical restraints, drug induced sedation or general anesthesia. General anesthesia is useful in control of the patients who cannot be treated in other ways. Additionally, general anesthesia provides more safe environment for medically compromised patients. The aim of the present study was to investigate a kind of disorder, sources of referral, preoperative oral condition, experience of dental visit, and performing general anesthesia or not of 930 disabled patients in Kyung-Hee University dental hospital for 30 years.
Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.
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