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당뇨환자에서 하치조신경 전달마취와 턱관절 탈구후 유발된 안면신경 마비 치험 1예 -증례보고-
이천의,유재하,최병호,김종배,Lee, Chun-Ui,Yoo, Jae-Ha,Choi, Byung-Ho,Kim, Jong-Bae 대한치과마취과학회 2011 Journal of Dental Anesthesia and Pain Medicine Vol.11 No.1
Bell's palsy is an isolated facial paralysis of sudden onset caused by a neuritis of the seventh nerve within the facial canal. It occurs often in the adult man with a history of recent exposure to local cold, such as sleeping next to an open window, or in some cases it occurs after infections of the nasopharynx or masticator spaces. Especially, this neuropathy have linked with the major collagen disorders (diabetes mellitus). A segmental demyelination develops rapidly, with vascultitis in microinfarcts and ischemia to the nerve segment. The authors experienced about the bizarre neurological symptom of Bell's palsy after inferior alveolar nerve block anesthesia and TMJ dislocation in diabetic mellitus. The early and correct consultation with the multiple medical and dental departments was important to prevent the inadequate care & medicolegal problems.
하악 차단마취하에 근관치료 후 유발된 진전(떨림) 치험 -증례 보고-
이천의,유재하,김종배,Lee, Chun-Ui,Yoo, Jae-Ha,Kim, Jong-Bae 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.2
Tremors are trembling movements and are seen in association with alcoholic intoxication, certain drugs, thyrotoxicosis, multiple sclerosis, hysteria, and nervous tension. Dental fears, such as, pain, drill, unknown, dependency, helplessness, mutilation and oral change, induce the neuroendocrine response (release of epinephrine and norepinephrine, etc). The clinical manifestations of epinephrine or other vasopressor overdose include : anxiety, tenseness, restlessness, throbbing headache, tremor, perspiration, weakness, dizziness, pallor, palpitation and respiratory difficulty. Signs of local anesthetic overdose appear clinically whenever the anesthetic level in the blood rises to an appropriate level in an individual. The clinical signs of moderate overdose levels include : talkativeness, apprehension, excitability, slurred speech, tremor and muscular twitching. This is a case report about the severe tremor care after the endodontic treatment under right mandibular block anesthesia in a 56-years old female patient.
간경화증과 구강전이 간암환자에서 과도한 재발성 치은출혈과 치통조절: 증례보고
이천의,모동엽,유재하,최병호,김종배,Lee, Chun-Ui,Mo, Dong-Yub,Yoo, Jae-Ha,Choi, Byung-Ho,Kim, Jong-Bae 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.6
The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.
어린이에서 상악 정중부 매복 과잉치 발치 시 즉시 배액술의 효과: 증례보고
이천의,유재하,최병호,설성한,김하랑,모동엽,Lee, Chun-Ui,Yoo, Jae-Ha,Choi, Byung-Ho,Sul, Sung-Han,Kim, Ha-Rang,Mo, Dong-Yub 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.3
Impacted supernumerary anterior teeth (mesiodens) usually are removed surgically with drug sedation and local anesthesia. After extraction of mesiodens, the wound are sutured and removable resin plate is then applied. In this operation, the postoperative bleeding and infection is likely to occur owing to postoperative accumulation of hematoma & seroma, psychologic stress and other contaminated factors (resin plate, poor oral hygiene, etc). So, the authors established the immediate rubber & iodoform gauze drainage into the sutured wound of mesiodens extraction for the prevention of postoperative bleeding and infection. The removable resin splint are not used because of the poor oral hygiene and economic factor. The results were more favorable without the postoperative blood oozing & wound infection in the dentistry (OMFS) of Wonju Christian Hospital.
다발성 경화증 노인환자에서 하악 전달마취 시행후 발생된 급성 요통치험 1예 -증례 보고-
이천의,모동엽,유재하,최병호,김종배,Lee, Chun-Ui,Mo, Dong-Yub,Yoo, Jae-Ha,Choi, Byung-Ho,Kim, Jong-Bae 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.2
Multiple sclerosis is a degenerative disease prevalent in northern climates, and its cause is unknown. The histopathological lesion in multiple sclerosis is the sclerotic "plague", a discrete focus of myelin loss with maintenance of axon segments and glial proliferation. The plaques may be seen in widely different brain and spinal tissues. The common causes of low back pain are psychosomatic disorder, myofascial pain dysfunction syndrome and herniation of nucleus pulposus. Local anesthetics cross the blood-brain barrier and the signs of CNS toxicity appear at a level between 4.5 and $7.0\;{\mu}g/ml$. This is a case report of acute back pain care after mandibular block anesthesia for the surgical extraction of mandibular root rests in an old aged woman with multiple sclerosis.
교도소에서 의뢰된 급성 하악 지치 주위염의 보존적 감염관리:
이천의(Chun-Ui Lee),유재하(Jae-Ha Yoo),최병호(Byung-Ho Choi),설성한(Sung-Han Sul),김하랑(Ha-Rang Kim),모동엽(Dong-Yub Mo),김종배(Jong-Bae Kim) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.1
In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.
다발성 전신질환자에서 국소마취하에 근관치료 중 유발된 실신과 혼수 치험 1예
유재하,최병호,이천의,김종배,Yoo, Jae-Ha,Choi, Byung-Ho,Lee, Chun-Ui,Kim, Jong-Bae 대한치과마취과학회 2011 Journal of Dental Anesthesia and Pain Medicine Vol.11 No.2
Altered consciousness may be the first clinical sign of a serious medical problem that requires immediate and intensive therapy to maintain life. There are many causes of the loss of consciousness in the dental office setting, such as, vasodepressor syncope, drug administration or ingestion, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, cerebrovascular accident, hyperglycemic reaction, acute myocardial infarction, acute allergic reaction and hyperventilation. This is a case report of syncope and coma during endodontic treatment of a maxillary third molar under local infiltration anesthesia in multiple medically compromised patient. The main cause was thought to be hypoglycemic reaction. The patient was transferred to the medical emergency room and cared properly by the emergency medical physicians. The prognosis was good.
설신경과 장협신경 전달마취 시행 후 발생된 설부와 협선반부의 장기간 이상감각증 관리 -증례보고-
김하랑,유재하,최병호,모동엽,이천의,김종배,Kim, Ha-Rang,Yoo, Jae-Ha,Choi, Byung-Ho,Mo, Dong-Yub,Lee, Chun-Ui,Kim, Jong-Bae 대한치과마취과학회 2009 Journal of Dental Anesthesia and Pain Medicine Vol.9 No.2
Trauma to any nerve may lead to persistent paresthesia. Trauma to the nerve sheath can be produced by the needle. The patient frequently reports the sensation of an electric shock throughout the distribution of the nerve involved. It is difficult for the type of needle used in dental practice to actually sever a nerve trunk or even its fibers. Trauma to the nerve produced by contact with the needle is all that is needed to produce paresthesia. Hemorrhage into or around the neural sheath is another cause. Bleeding increases pressure on the nerve, leading to paresthesia. Injection of local anesthetic solutions contaminated by alcohol or sterilizing solution near a nerve produces irritation; the resulting edema increases pressure in the region of the nerve, leading to paresthesia. Persistent paresthesia can lead to injury to adjacent tissues. Biting or thermal or chemical insult can occur without a patient's awareness, until the process has progressed to a serious degree. Most paresthesias resolve in approximately 8 weeks without treatment. In most situations paresthesia is only minimal, with the patient retaining most sensory function to the affected area. In these cases there is only a very slight possibility of self injury. But, the patient complaints the discomfort symptoms of paresthesia, such as causalgia, neuralgiaform pain and anesthesia dolorosa. Most paresthesias involve the lingual nerve, with the inferior alveolar nerve a close second. This is the report of a case, that had the persistent paresthesia care on left lingual & buccal shelf regions after the lingual and long buccal nerve block anesthesia.
기관지 천식과 편도 증식증 환자에서 상악 정중부 과잉치 발치 전 포크랄과 케타민 투여 진정요법 시 발생된 기도폐쇄와 호흡장애 -증례 보고-
최영수,강상훈,김문기,이천의,유재하,Choi, Young-Su,Kang, Sang-Hoon,Kim, Moon-Key,Lee, Chun-Ui,Yoo, Jae-Ha 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1
The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.
하악골 복합 골절시 구내 열창부 상에 추가 절개 배농술을 이용한 단기간 가변적 악간고정 관리: 증례보고
모동엽,유재하,최병호,김하랑,이천의,유미현,Mo, Dong-Yub,Yoo, Jae-Ha,Choi, Byung-Ho,Kim, Ha-Rang,Lee, Chun-Ui,Ryu, Mi-Heon 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.3
Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.