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RISS 인기검색어
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- 저자 : 이수언 ( Soo Eun Lee ) (검색결과 4 건)
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임지은,이수언,안효정,박재홍,최성철,Lim, Ji Eun,Lee, Soo Eon,Ahn, Hyo Jung,Park, Jae-Hong,Choi, Sung Chul 대한치과마취과학회 2012 Journal of Dental Anesthesia and Pain Medicine Vol.12 No.4
Severe한 혈우병 B 환아가 소아과에 입원하여 세계혈우병연맹(World Federation of Hemophilia, WFH) 지침서에 따라서 응고인자 수준을 유지하면서 다수의 발치를 포함한 관혈적 치과 치료를 받았다. 이와 같이 혈우병 환자에서 다수의 발치를 시행할 때 주기적인 혈액검사를 통한 응고인자 수준의 관리와 복잡한 의과적 처치가 요구된다. 따라서 다수의 발치가 요구되는 경우 전신마취 하에 가능한 모든 치과치료를 시행하는 것이 효과적이고 효율적인 방법이 될 수 있다. Hemophilia, the most common of the inherited bleeding disorder, is the result of a deficiency of clotting factor. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. We report on the diagnosis and treatment of a 9-year-old boy having severe hemophilia visited our department with the chief complaints of pus discharge on the left lower molar region. In the clinical and radiographic examination, periapical abscess and dental caries were diagnosed. Considering complexity of the treatment and complication in the coagulation, it was decided to carry on the treatment under general anesthesia. Clotting factor IX concentrates were intended to provide 50-70% plasma level. Pulpectomy, resin restoration and Stainless steel crown were given under general anesthesia. Several teeth were extracted and the sockets were packed with Surgicel$^{(R)}$ (Oxidized Regenerated Cellulose, Johnson and Johnson Co. Neuchatel, Switzerland) under general anesthesia. Transpalatal arch and lingual arch were given for maintaining the extracted space before discharged. For people with severe hemophilia, factor replacement is necessary before scaling, surgery or regional block injections. Therefore, if several extractions are needed, dental care under general anesthesia would be effective and efficient management.
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이영은(Young Eun Lee),박재홍(Jae-Hong Park),김광철(Kwang Chul Kim),이수언(Soo Eon Lee) Asia association of Disability and Oral health 2013 International Journal of Disability and Oral Healt Vol.9 No.2
본 증례에서는 재생불량성 빈혈 환자의 치료에 있어 감염가능성과 출혈 가능성을 고려하였으며 의과적 관리와 병행한 치과 치료를 성공적으로 시행하였다. 재생불량성 빈혈환자의 사망원인은 감염과 출혈이 주를 이루므로 치과의사는 치료하기 전 이와 관련된 혈핵학적 특성을 알아야 하며, 가능한 치과 치료의 범위와 개입 시기를 이에 기반을 두어 판단하여야 한다. 치과 치료 전 혈소판 수치와 절대 호중구수를 고려하여 수혈과 예방적 항생제의 필요 여부를 결정하여야 할 것이다. 또한, 이러한 환자에 있어 예방치료와 구강위생 관리는 일반 환자에서 중요하다. 주기적 검진 및 구강위생에 대한 교육이 보다 강조되어야 할 것이다. Aplastic anemia (AA) is a blood dyscrasia characterized by hypocelluar bone marrow and peripheral blood pancytopenia. Symptomatology depends on the severity of pancytopenia. Patients with AA are susceptible to infection because of agranulocytosis. Hemorrhage caused by thrombocytopenia can be fetal to these patients. Therefore dental procedure potentially can cause serious complications and should be applied with caution. A 6-year-old boy with moderate aplastic anemia was referred to treat dental caries. General dental procedure including resin filling, preformed crown, pulpectomy and extraction was performed under sedation. Combination of modalities such as platelet transfusion, oral hygiene instruction, and dental prophylaxis was also implemented. In this report, the dental and medical management of a patient with AA was presented. Interdisciplinary care should be administered to patients with AA.
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한국인 중증 외상 환자에서 촬영한 경추 외측면 단순 방사선 영상의 적절성
이경학 ( Kyung Hag Lee ),김영철 ( Yeong Cheol Kim ),최석호 ( Seok Ho Choi ),한국남 ( Gook Nam Han ),이수언 ( Soo Un Lee ),이정은 ( Jung Eun Lee ),서길준 ( Gil Joon Suh ),윤여규 ( Yeo Kyu Yoon ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4
Purpose: The objective of this study was to investigate the appropriateness of the cross table lateral cervical X-ray used in the emergency department for severely traumatized Korean patients. Methods: Patients visiting our institution from May 2011 to May 2012, who had injury severity score (ISS) > 15 and who received a cervical X-ray in the emergency department, were included in this study. Data including demographics, ISS score, GCS score, and place where the x-ray was taken were collected to evaluate their relationship with appropriate coverage of the cervical X-ray. The appropriateness of a cervical cross lateral view Xray was evaluated using exposure of the basion, and the opisthion, as well as the distal level of exposure. Results: Fifty-two patients were included in this study. The identification rate of the basion was 79.2%, and the identification rate of the opisthion was 88.7%. Complete exposure of C7/T1 was accomplished in 3.8% of the patients. The ISS was higher for X-ray taken in the trauma bay, but the range of exposure showed no difference between the places where the X-rays taken. Patients who had exposure of C 5/6 or more had lower body weight and body mass index (BMI) compared with unexposed patients. Conclusion: In severely traumatized Korean patients, the adequacy of the cross table lateral cervical X-ray was inappropriate in most cases. No difference was observed in the exposure range between the places where the X-rays were taken, and patients with less exposure showed higher body weight and higher BMI. (J Trauma Inj 2012;25:241-246)
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김영철 ( Yeong Cheol Kim ),최석호 ( Suk Ho Choi ),한국남 ( Kuk Nam Han ),이경학 ( Kyung Hak Lee ),이수언 ( Soo Eun Lee ),서길준 ( Gil Joon Suh ),윤여규 ( Yeo Kyou Yoon ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2
Purpose: We analyzed the medical costs for severely traumatized patients according to the severity and medical performance so that we couldimprove the financial balance of the trauma center. Methods: Retrospective analysis was performed on patients visiting SNUH Trauma Center from May 2011 to August 2011. Among a total of 55 severely traumatized patients, 31 patients whose medical bills were available and categorized were included in this study. The injury severity score (ISS) was calculated from the abbreviated injury score (AIS), which was updated in 2008,for each patient to assess the severity of injury. Major trauma was defined as an ISS above 15. Results: The 31 patients in this study included 20 males and 11 females. The average ISS was 33.23±16.65 points. We categorize the patients into three groups according to ISS, 16-24: group 1, 25-40: group 2, and above 41: group 3. Total incomes, admission fees, surgery fees, and imaging test fees are shown in table 1. The costs seem to be higher costs in group 2, but this result has no statistical significance. Statistical significantly data are as follows: high radiologic test fees in group 1, short hospital stay in groups 1 and 2, and short ICU stay in group 1. The averagehospital stay was 17 days, and the average emergency intensive care unit (EICU) stay was 7.5 days. Although the EICU stay was only 44% of the total hospital stay, the income from the EICU covers 79.4% of the total hospital income. Conclusion: From this study, we found several items that show relatively high medical income from severely traumatized patients visiting the SNUH Trauma Center. Most of the medical fees arise in the early phase of acute medicine usually in the ICU. Efforts to identify the items with high income and to minimize expenses will improve the financial structure of the Trauma Center, which is facing a budget crisis.
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