알레르기접촉피부염 환자(영서지역, 2005~2010년)의 첩포검사(TRUE Test) 결과에 관한 고찰

설근동 ( Geun Dong Sul ),이성율 ( Sung Yul Lee ),김재홍 ( Jae Hong Kim ),홍한나 ( Han Nah Hong ),천재순 ( Jae Sun Chun ),안성구 ( Sung Ku Ahn ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.7

Background: Since 2005, the commercial patch test panel, the TRUE-test, has been available. However, there have been no reports regarding the results of the TRUE-test compared with previously used Korean Standard Series in Korea. Objective: This study aimed to evaluate the prevalence of the contact allergy, causative allergens, and source of allergens in patients who were diagnosed with allergic contact dermatitis, and to compare the findings with previously used Korean Standard Series. Methods: We reviewed the results of the TRUE-test from 2005~2010 in Wonju Christian Hospital. We patch-tested 843 patients who were diagnosed with allergic contact dermatitis. The patch test reading was performed on day 2 and days 3 or 4, according to the patients` needs. Epidemiologic findings of patients and the results of the patch tests were analyzed. Results: A total of 843 patch-tested cases were compiled and analyzed. Of 843 patch-tested patients (male, 309; female, 534), 65.8% had at least 1 positive reaction and 30.2% at least 2 positive reactions. The highest age distribution was the 5th decade in females. The face, with the exception of the eyelids, ears, and lips, was the most frequently affected site (comprising 50.3%). The highest sensitization rates were found with nickel (29.1%), thiomersal (10.9%), and cobalt dichloride (9.7%). The lowest positivity included caine mix (0.7%), mercaptobenzothiazole (1.2%), and quinolone mix (1.2%). Metal allergens displayed higher positive rates than any other standard allergens. The overall prevalence was similar with a recent report in Korea. Conclusion: There was no significant difference in the overall prevalence of the most sensitized allergen compared with the reports about previously used Korean standard series.

전신마취 도중 유발된 아나필락시스 -증례보고-

최병호,설성한,유재하,Choi, Byung-Ho,Sul, Sung-Han,Yoo, Jae-Ha 대한치과마취과학회 2006 Journal of Dental Anesthesia and Pain Medicine Vol.6 No.2

Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction. Most fatalities from anaphylaxis occur within the first 30 minutes postantigenic exposure. The mechanism of generalized anaphylaxis is the reaction of IgE antibodies to an allergen that causes the release of histamine, bradykinin, and others. These chemical mediators cause the contraction of smooth muscles of the respiratory and intestinal tracts, as well as increased vascular permeability. Four major clinical symptoms are recognized: skin reactions, smooth muscle spasm (gastrointestinal and genitourinary tracts and respiratory smooth muscle), respiratory distress, and cardiovascular collapse. Epinephrine is the drug of choice for the management. Its syrnpathomimetic effects directly counteract most aspects of the attack. Respiration must be immediately supported by the establishment of a patent airway along with artificial ventilation. The circulation should be supported and the existing hypotension overcome by placing the victim in a position to allow gravity to aid venous return and by administering intravenous fluids, vasopressors, and corticosteroids. When an imperceptible pulse is evident, external cardiac compression must also be instituted. This is a case report of anaphylactic shock care during general anesthesia, possibly due to penicillin, pancuronium and others.

전신질환자에서 과도한 감염치아부 국소마취시 스트레스 감소법 : 문헌적 고찰 및 증례보고

유재하,최병호,설성한,김하랑,모동엽,Yoo, Jae-Ha,Choi, Byung-Ho,Sul, Sung-Han,Kim, Ha-Rang,Mo, Dong-Yub 대한치과마취과학회 2008 Journal of Dental Anesthesia and Pain Medicine Vol.8 No.1

Common dental procedures (local anesthesia and dental treatment) are potentially stress-inducing in many patients, especially medically compromised patients. The body response to dental stress involves the cardiovascular system (an increase in cardiovascular workload), the respiratory organ and the endocrine system (change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment: do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given. This protocol is predicated on the belief that the prevention of or reduction of stress ought to begin before the start of an appointment, continue throughout treatment, and, if indicated, into the postoperative period. The authors used the stress reduction protocol in the care of local anesthesia infected teeth in medically compromised patients. The final prognosis was comfortable without any complications.

장기간의 보존적 배농술로 치료된 하악 복합골절 관련 광범위 골수염 치험 : 증례보고

김하랑,유재하,최병호,설성한,모동엽,이천의,Kim, Ha-Rang,Yoo, Jae-Ha,Choi, Byung-Ho,Sul, Sung-Han,Mo, Dong-Yub,Lee, Chun-Ui 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.6

Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

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.

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.

조기 치근관 배농술을 이용한 하악 골절선상 감염치아들의 보존적 관리:

모동엽(Dong-Yub Mo),유재하(Jae-Ha Yoo),최병호(Byung-Ho Choi),설성한(Sung-Han Sul),김하랑(Ha-Rang Kim),이천의(Chun-Ui Lee) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.4

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound(pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.