• Title/Summary/Keyword: severe pain

Search Result 1,458, Processing Time 0.036 seconds

A CASE REPORT OF COMPLICATIONS DURING MANDIBULAR TRANSVERSE SYMPHYSIS WIDENING (하악 이부 확장술 시 나타나는 합병증의 치험례)

  • Suh, Chung-Whan;Kang, Kyung-Hwa;Choi, Moon-Gi
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.30 no.5
    • /
    • pp.480-488
    • /
    • 2008
  • Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

CONSERVATIVE TREATMENT OF DENTIGEROUS CYSTS ; 5 CASES (소아에서 발생한 함치성 낭종의 보존적 치료의 치험례 ; 5 례)

  • Jun, Chang-Hun;Jeong, Jong-Cheol;Song, Min-Seok;Seo, Ji-Hoon;Kim, Sung-Beom;Choi, Se-Hoon;Kim, Hyeon-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.29 no.2
    • /
    • pp.135-139
    • /
    • 2003
  • A dentigerous cyst is an epithelium-lined sac that surrounds the crown of an unerupted tooth or odontoma. And the most common sites of this cyst are the mandibular and maxillary third molar and maxillary cuspid a areas. Clinically, expansion of bone with subsequent facial asymmetry, extreme displacement of teeth, severe root resorption of adjacent teeth and pain are all possible sequelae of this cyst. The standard treatment for a dentigerous cyst is enucleation and extraction of the involved tooth. But in large cysts, this can lead to functional, cosmetic and psychologic consequences to the patients. So recently, more conservative methods are used. We report 5 cases of dentigerous cysts in pediatric patient which were treated by a conservative approach, By this methods, we can preserve teeth and guide eruption of the teeth which are involved in cystic area.

Full thickness skin grafts from the groin: donor site morbidity and graft survival rate from 50 cases

  • Kim, Somi;Chung, Seung-Won;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.39 no.1
    • /
    • pp.21-26
    • /
    • 2013
  • Objectives: Full thickness skin grafts (FTSG) offer several advantages; they are esthetically superb, have less postoperative shrinkage, and offer minimal postoperative pain and scar formation at the donor site. As a donor site of FTSG, the groin offers a relatively large area of skin with high elasticity. The aim of this study was to evaluate FTSG from the groin for reconstruction in oral and maxillofacial surgery. Materials and Methods: In a retrospective study, 50 patients (27 males, 23 females) who received FTSG from the groin were evaluated for their operation records, clinical photography, and medical records. Results: The width of skin from the groin was distributed from 2-8 cm (mean: 5.1 cm) at the donor site, while the long axis length was distributed from 3-13 cm (mean: 7.4 cm). A high number of patients, 47 patients (94%) out of 50, showed good healing at the donor site. Wound impairment was seen in 3 patients (6%), minor wound dehiscence in 2 patients, and severe wound dehiscence in 1 patient. In the recipient site, delayed healing was observed in 2 patients (4%). Conclusion: FTSG from the groin to repair soft tissue defects in reconstruction surgery is a good method due to the relatively big size of the graft, decreasing morbidity at the donor site, and higher graft survival rates.

Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old (55세 이상 무지외반증 환자의 근위부 절골술을 이용한 치료)

  • Park, Han-Sung;Park, Hyung-Taek;Lee, Ghun-Shik;Kim, Sang-Hyo;Lee, Kyung-Tai
    • Journal of Korean Foot and Ankle Society
    • /
    • v.9 no.1
    • /
    • pp.69-73
    • /
    • 2005
  • Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

  • PDF

Proximal Metatarsal Wedge Osteotomy with Single Screw Fixation in Treatment of Hallux Valgus (무지 외반증의 치료에서 단일 나사못을 이용한 근위 중족골 쐐기 절골술)

  • Choi, Jae-Yeo;Shin, Hun-Kyu;Chang, Il-Sung;Kang, Dong-Ho
    • Journal of Korean Foot and Ankle Society
    • /
    • v.9 no.1
    • /
    • pp.87-93
    • /
    • 2005
  • Purpose: We conducted this study to examine the clinical results of the proximal metatarsal wedge osteotomy using a single screw fixation and the distal soft tissue procedure in patients with moderate to severe hallux valgus deformity. Materials and Methods: Between February 2002 and February 2004, we performed these procedures on 12 patients (15 cases). The 6 cases of all patients had mild to moderate instability in the first MTC (metatarsocuneiform) joint. We estimated the clinical outcomes, the radiological findings and complications. Results: AOFAS score was improved from preoperative 41.5 points to 87.7 points lastly on average. The mean correction angle of HVA and IMA was $23.8^{\circ}$ and $6.6^{\circ}$, respectively. The mean position of tibial sesamoid was 2.67 before surgery and 0.87 after surgery. The mean shortening of the first metatarsal bone was 3.07 mm after surgery. There was no pain and complications on the first MTC joint except the breakage of screw in one case and instability of the first MTC joint was improved postoperatively. Conclusion: We obtained good clinical and radiographic outcomes in our series. So, proximal metatarsal wedge osteotomy using a single screw fixation and distal soft tissue procedure seems one of the good surgical treatments for moderate hallux valgus deformity.

  • PDF

Factor analysis of Presence (Presence련와 관련된 요인 분석)

  • 조계화;성기월
    • Journal of Korean Academy of Nursing
    • /
    • v.30 no.1
    • /
    • pp.225-239
    • /
    • 2000
  • This study is a research of conceptual development to find the factors of presence. The concept and the definition of presence received from literary review. On the basis of these findings, we formulate the contents of presence through structured interview guide composed of open-ended questionnaire which included the frequency, attitude, and posture. We selected 104 samples who are the patients, doctors, nurses, and other health providers. And then the contents of presence were established after integrating the formulated contents and putting them in order. The categorizing of the presence was made after discussing with specialist in this field. By using the selected contents, we made 25 statements of presence which were categorized into three factors. The results were as follows: 1. The definition of presence is being with at the same time and space, making attention with openness, and the therapeutic interaction with empathy. 2. The contents of presence through personal interviews are The time required is 5 minutes(46.15%), 2-3 minutes(34.61%), and 10 minutes (15.38%) respectively. The frequency of visiting is 3 times(39.20%), every time(23.07%), and more than 5 times(20.19%) respectively. \circled2 In case of being with nurse is having pain(39.42%), suffering trouble or severe fear(9.61%), feeling discomfort(8.65%), taking care of wound(7.69%), and other unfavorable symptoms(6.73%) respectively. \circled3 The posture being with nurse is depends on the situations(63.46%), sitting(26.92%), and standing(9.61%) respectively. Eye contact with nurse is face to face(78.84%), depends on the situations(20.19%), and not face to face(0.96%) respectively. \circled4 The attitudes of comfort are explaining about disease(23.07%), holding on hands (14.42%), touching on the suffering parts (11.53%), and unconditionally being with(7.69%) respectively. \circled5 Nurses' caring actions are kindness (27.88%), replying to the question (12.50%), smiling(10.57%), bright appearances (8.65%), and right and quick treatment(8.65%) respectively. \circled6 The effects of being with are peaceful mind(58.65%), quick recovery(13.46%), and decrease in fear(12.50%) respectively. \circled7 The attitudes of being with are listening (11.53%), recognition(8.65%), talking about discomfort(8.65%), and answering kindly (7.69%) respectively. 3. From the analysis of presence factors, 25 statements and 3 categorized factors are presented.

  • PDF

Measuring depth of anesthesia with Bispectrum and DFA analysis of the EEG (뇌파의 바이스펙트럼과 DFA 분석을 이용한 마취심도 측정)

  • Ye, Soo-Young;Eum, Sang-hee
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
    • /
    • 2015.05a
    • /
    • pp.397-400
    • /
    • 2015
  • Due to the anesthesia process is inappropriate on the operation, awakening state was appeared. Because of that patients suffered from severe mental and physical pain. To prevent the state, it is necessary to monitor the patients by measuring the depth of anesthesia. In this study, we investigate the possibility of the development of actual surgery available quantitative indicators. The DFA(detrended fluctuation analysis) which is included the correlation property of the EEG is used to analysis the depth of anesthesia and bispctrum index. In the results, at the pre-operation, the peak of bispectrum was widely distributed, DFA value was decreased. At the during operation, bispectrum was concentrically appeared in the low frequency area. At the post operation, bispectrum and DFA was both returned to the pre-operation state. As a result, we confirmed to be close correlation between the peaks of the bispectrum and DFA value.

  • PDF

Hyperventilation During Local Anesthesia in Acute Odontogenic Infectious Lesion - Report of two cases - (급성 치성감염 병소에서 국소마취 중 유발된 과환기 -증례 보고-)

  • Yoo, Jae-Ha;Kim, Hyun-Sil;Baek, Sung-Hum;Yoo, Tae-Min;Lee, Ji-Woong;Chung, Won-Gyun
    • Journal of The Korean Dental Society of Anesthesiology
    • /
    • v.2 no.2 s.3
    • /
    • pp.107-113
    • /
    • 2002
  • Hyperventilation is defined as ventilation in excess of that required to maintain normal blood $PaO_2$ and $PaCO_2$. It is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, two cases of hyperventilation were occurred during local anesthesia for incision and drainage of acute odontogenic infectious lesions. We suggest that the dental patients with acute odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

  • PDF

Tosufloxacin Tosylate Increased the Liver Enzyme Levels in a Bladder Cancer Patient with Normal Liver Functions: a Case Report (정상 간기능을 가진 방광암환자에서 간효소 수치를 올리는 Tosufloxacin Tosylate: 증례보고)

  • Choi, Eun Joo;Song, In Ja;Rhew, Ki Yon;Yoon, Hyonok
    • Korean Journal of Clinical Pharmacy
    • /
    • v.25 no.1
    • /
    • pp.56-58
    • /
    • 2015
  • Summary: We report the first hepatic adverse effect of tosufloxacin tosylate in a muscle invasive bladder cancer patient with normal liver functions and with scheduling to undergo a surgical operation for a neobladder. Tosufloxacin tosylate 150 mg was administered to a 57-year-old man who maintained transurethral resection of bladder tumor (TUR-BT) postoperative multiple medications. His labs presented significant increases in alanine amino transferase (ALT) and aspartate amino transferase (AST) levels with 2-week compliance of 150 mg tablet three times a day. After discontinuing tosufloxacin tosylate, the levels slowly decreased and completely returned to normal ranges without any intervention in a few weeks. The Naranjo Causality Algorithm indicates a probable relationship between increased ALT and tosufloxacin. The patient was to have the second surgical operation as scheduled after getting normal range of ATL level. Therefore, tosufloxacin should be avoided in patients at risk for having liver dysfunctions or diseases if the patients have a schedule for any operation. Background: Tosufloxacin tosylate has been shown to have favorable benefits as an antibiotic. Tosufloxacin tosylate may be considered to have the adverse effects such as nauseas, vomiting, diarrhea, abdominal pain, stomatitis, tendonitis, tendon rupture, headache, dizziness, drowsiness, insomnia, weakness, agitation including hemolysis in the event of glucose-6-phosphate dehydrogenase deficiency as other fluoroquinolones. More severe adverse reactions of tosufloxacin tosylate over the above common adverse effects of fluoroquinolones were thrombocytopenia and nephritis. It also is not well known that tosufloxacin can cause hepatic problem. Here the study reports the first hepatic reaction from tosufloxacin and might arouse heath care providers' attention to appropriate drug choice for patients.

The Factors Affecting the Depression in Pneumoconiosis Patients (진폐환자의 우울에 영향을 미치는 요인)

  • Bak, Jue Hyeon;Lim, Hyeon Woo;Chae, Jung MI;Cho, Hyun Ju;Jung, Hye Sun;Jo, Sun Jin;Lee, W.C.
    • Korean Journal of Occupational Health Nursing
    • /
    • v.16 no.1
    • /
    • pp.28-36
    • /
    • 2007
  • Objectives: The objective of this study was to analyze factors affecting depression in pneumoconiosis patients. Methods: The subjects were 200 pneumoconiosis patients hospitalized in Pneumoconiosis Hospitals in An-san and Tae-beck. Collected 114 surveys were used in this study among 200 surveys since 86 surveys offered insufficient data. SAS for Windows 8.01 was used to analyse the data Results: Percentage of normal and mild depression is 2.6%, Percentage of moderate depression is 14.9%, Percentage of severe depression is 79.8%. In order to analyze the factors affecting depression rate, the factors with p-values less than 0.1, such as age, education, religion, work department, hospitalized period, physical pain existence, daily living ability, family supports and internal locus of control, were selected as independent factors and analyzed using a stepwise multiple regression. As results, the factor that affected the rate of depression were of the age, education, ADL(Activities of Daily Living), the internal locus of control, family support. Conclusion: It is necessary to develop health program which can improve the patient's ADL(Activities of Daily Living), enforce internal locus of control to minimize the depression rate in pneumoconiosis patients.

  • PDF