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기도 유지가 어려운 정신지체 환자에서 후두마스크 삽입 하 치과치료
이영은(Young-Eun Yi),서광석(Kwang-Suk Seo),김현정(Hyun-Jeong Kim),신터전(Teo-Jeon Shin) Asia association of Disability and Oral health 2008 대한장애인치과학회지 Vol.4 No.2
A female patient (14 years-old) with mental retardation was scheduled for ambulatory general anesthesia to treat peri-apical abscess and multiple dental caries. She had got cleft palate plasty at 5 years, but there was no past history of difficulty airway during general anesthesia or airway obstruction. Following induction of anesthesia using an inhalational anesthetic technique, conventional naso-tracheal intubation was tried. However, with conventional intubation technique we could not insert tube. And following several trial of intubation with laryngoscope, she developed an upper airway obstruction. Her lungs could not be ventilated using a facial mask and oxygen saturation was decreased. A #3 laryngeal mask airway (LMA) was inserted immediately, which allowed us to ventilate her lungs and restore the oxygen saturation. And dental treatment was carried out under LMA insertion successfully.
대학생들의 외식시 웰빙 음식에 대한 태도 및 인식도 조사
이영은(Young Eun Lee),서유진(Yu Jin Seo),양송이(Song Yi Yang) 충북대학교 생활과학연구소 2007 생활과학연구논총 Vol.10 No.2
The purpose of this study was to examine the customers" attitude and perceptions on the well-being manu of restaurant food service operations. Well-being is one of the main factors affecting the growth of the food service industry. A questionnaire survey of 250 consumers at restaurant food service operations in Korea was conducted and 207 completed questionnaires were available for the purpose of the statistical education. Statistical analyses were made of raw data by way of using the SAS v8.2 program. Customers" attitude and perception scale were composed of 5-likert scales. The main results of this study were summarized as follows: Food taste and food freshness were top priorities for the customers patronizing the well-being menu at the restaurant food service operations. Customers" attitude was above 3 point among 5 scales in choice intention on well-being menu at the food service operations. These choice intentions on well-being menu had no relations among ages significantly. Customers had a preference of nutrition and taste of well-being menu to price of the menu at the food service operations. Customers" attitude on the well-being menu was significantly different from the purpose of choice intentions.
경비기관내튜브의 발관 지연에 따른 환자의 불편감 정도 분석 -A Pilot Study
심정환,이영은,김현정,염광원,박윤기,서광석,Shim, Jung-Hwan,Yi, Young-Eun,Kim, Hyun-Jeong,Yum, Kwang-Won,Park, Yun-Ki,Seo, Kwang-Suk 대한치과마취과학회 2007 Journal of Dental Anesthesia and Pain Medicine Vol.7 No.1
Background: It is well known that nasotracheal intubation is comfort for patient compared to oral intubation. We sometimes delay extubation when it is thought that the patient can not maintain airway, or there may be other emergency associated with airway. And we sometimes experience complaint of discomfort of nasotracheal tube. But, we could not find any report on degree of discomfort of delayed nasotracheal intubation. Methods: Eighteen patients in whom extubation of nasotraceal tube was delayed after operation because of difficulties of airway mamagement were selected. We surveyed the discomfort of nasotracheal tube with 0 to 10 visual analogue scale (VAS) and compared with the pain of operation site (VAS). Result: The VAS of nasotracheal intubation was $6.7{\pm}3.4$, and VAS of the primary operation site was $3.5{\pm}2.4$, and VAS of flap harvest site was $5.5{\pm}2.7$. 10 of the patients complained of nasotracheal suction extremely and 6 patients complained of respiratory difficulties. Conclusions: Nasotracheal intubation was discomfort and there must be intervention.
정준민,서광석,이영은,한희정,한진희,김혜정,신터전,김현정,염광원,장주혜,Chung, Jun-Min,Seo, Kwang-Suk,Yi, Young-Eun,Han, Hee-Jung,Han, Jin-Hee,Kim, Hye-Jung,Shin, Teo-Jeon,Kim, Hyun-Jeong,Yum, Kwang-Won,Chang, Ju-He 대한치과마취과학회 2008 Journal of Dental Anesthesia and Pain Medicine Vol.8 No.1
Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.
정신지체 환자에서 외래전신마취 하 치과치료 후 발생한 폐렴 -증례보고-
서광석,장주혜,신터전,이영은,김현정,Seo, Kwang-Suk,Chang, Ju-He,Shin, Teo-Jeon,Yi, Young-Eun,Kim, Hyun-Jeong 대한치과마취과학회 2008 Journal of Dental Anesthesia and Pain Medicine Vol.8 No.2
A 15-years-old female patient with seizure disorder and pervasive developmental disorder was scheduled for dental treatment under ambulatory general anesthesia. She had past history of pneumonia and herpes encephalitis when she was 3 year old. Because of sever mental retardation and behavior disorder, routine laboratory test was substituted with physical exam and medical records of department of pediatrics. A few days before general anesthesia, she showed slight common cold, but pediatric consult had reported that there was minimal risk in general anesthesia. After 4-hour general anesthesia, she became critically sick with high fever, cough and malaise. After 10-day hospitalization with pneumonia and sepsis, she could go home.
정신지체가 동반된 뇌성마비 환자의 임플란트 치료를 위한 CT 촬영 시 진정법 시행
서광석(Kwang-Suk Seo),이주환(Ju-Hwan Lee),신터전(Teo-Jeon Shin),이영은(Young-Eun Yi),김현정(Hyun-Jeong Kim),염광원(Kwang-Won Yum),김명진(Myung-Jin Kim) Asia association of Disability and Oral health 2008 International Journal of Disability and Oral Healt Vol.4 No.1
A 33-years-old female pateint with cerebral palsy showing spastic quardriplegia and severe mental retardation was scheduled for dental implant restorations. Before implant surgery we had to take implant CT. But, because of her involuntary motion and communication difficulty, sedation was needed in order to take CT. After 8 hour NPO, propofol infusion sedation with TCI (target controlled infusion) system was administered. The propofol blood concentration of the patient was maintained 2-3 μ/ml to keep deep sedation to prevent uncontolled movement. During sedation, we monitored ECG, pulse oximetry, blood pressure, capnometry for patient safety. Oxygen was administered via nasal prong for preventing hypoxemia and to keep airway during sedation some bands were applied to lift mandible. Total duration was 20 minutes for taking CT, and she was discharged from hospital after 30 minute rest without complication.