자폐 환자의 자해로 인한 구강 내 손상

지은혜(Eunhye Ji),이효설(Hyo-seol Lee),최형준(Hyung-Jun Choi),김성오(Seong-Oh Kim),최병재(Byung-Jai Choi),손흥규(Heung-Kyu Son),이제호(Jae-Ho Lee) Asia association of Disability and Oral health 2012 대한장애인치과학회지 Vol.8 No.1

자폐증 및 정신 지체가 있는 환자의 입술 깨물기 증상을 mouthguard를 사용하여 성공적으로 조절하였다. 치과적으로 접근 가능한 구강 내 자해 증상의 치료는 가철성 혹은 고정성 장치를 이용하거나 관련 치아의 발치, 악교정 수술 등을 시도할 수 있으며 각 환자에 맞는 적절한 치료법을 선택하는 것이 중요하다. 자해 행동이 일시적으로 개선되었다 해도 재발의 가능성이 높으므로 장기적인 관리와 소아정신과와의 협진 하에 정신심리학적 환경 개선 및 약물 치료가 병행되어야 할 것이다. Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

Williams Syndrome 환자에서의 scissor bite correction

지은혜(Eunhye Ji),최형준(Hyung-Jun Choi),김성오(Seong Oh Kim),손흥규(Heung-Kyu Son),이제호(Jae-Ho Lee) Asia association of Disability and Oral health 2011 International Journal of Disability and Oral Healt Vol.7 No.1

11세 여환이 저작시 불편감을 주소로 내원하여 임상 구강 검사 결과 하악 우측 구치부의 scissor bite이 관찰되었다. 내원 당시 환아는 치과 치료에 대한 두려움과 거부감을 나타냈고 이에 1년 동안 정기 검진을 하여 환자와의 신뢰관계를 형성 후 교정치료가 가능하였다. Williams Syndrome 환자의 경우 사교적이며 친밀한 성격임에도 치과종사자나 치과 치료에 대한 두려움을 가질 수 있어 치료를 시작하기 전 환자와 치과 종사 간의 관계 형성을 통한 신뢰를 획득함으로 더 나은 질의 치료를 시행할 수 있을 것이다. Williams syndrome(WS) is a congenital disorder caused by a deletion of the Elastin gene and other contiguous genes at chromosome 7. Patients with WS are at a high risk of dental caries, and they also have a higher frequency of dental malocclusion compared to normal children. Malocclusion occurs in 85% of individuals with WS, which results from combined causes, such as tongue thrust, hypotonia, and connective tissue abnormality. An 11 year-old girl with WS presented scissor bite on the lower right second premolar and the first molar, and she complained of difficulty in chewing. Active lingual arch was used instead of removable appliance, considering the patient’s cooperation ability. Unilateral posterior scissor bite was corrected in 7 months. Although patients with WS are sociable and friendly, dental treatment can be a fearful experience for them. Efforts to build rapport with the patients with WS resulted in improved relationship between the doctor and patient, and desired outcome of dental treatment was achieved with patient’s improved cooperation

기술·가정교과 수강 고등학생의 예비부모교육에 대한 인식 - 포커스 그룹 인터뷰를 중심으로 -

지은혜(Eun Hye Ji),최새은(Sae Eun Choi) 한국생활과학회 2018 한국생활과학회 학술대회 Vol.2018 No.11

기술 · 가정교과를 이수한 고등학생의 예비부모교육에 대한 이해 : 포커스 그룹 인터뷰를 중심으로

지은혜(Ji, Eun Hye),최새은(Choi, Saeeun) 한국생활과학회 2020 한국생활과학회지 Vol.29 No.2

The purpose of this study was to assess the changes in the knowledge and attitudes on parenthood after learning topics of parenting education in Technology-Home Economics (T&HE) classes. For this purpose, four focus group interviews were conducted with the first and second-grade high school students in A and B high school in Daejeon. Each focus group comprised eight male or eight female students who enrolled in T&HE classes taught by the same teacher. The results of this study are as follow. First, even students enrolled in the T&HE class did not recognize that they learned content related to parenting education, and strongly agreed with the necessity of learning parenting education in adolescence. Second, the primary goals of parenting education should be for adolescents to know about human sexuality and teen pregnancy in understanding the inherent responsibility as a parent and to acquire practical nurturing skills. Third, the topics that should be stressed in parenting education for high school students should include the practical aspects of pregnancy, childbirth, parental role or upbringing, and changes in family relations. Fourth, the parenting education provided by the Technology-Home Economics class would contribute to adolescents understanding their parents and promoting gender equality by knowing the importance of co-parenting. This study suggests that future research must develop a systematic and effective parenting education curriculum to consider practical goals from the perspective of adolescents.

결핵성 공동으로 오인된 외상 후 발생한 가성 폐낭종 1예

이현정 ( Hyun Jeong Lee ),강지영 ( Ji Young Kang ),임선미 ( Sun Mie Yim ),지은혜 ( Eun Hye Ji ),김지현 ( Ji Hyun Kim ),김세원 ( Sei Won Kim ),이상학 ( Sang Haak Lee ),문화식 ( Hwa Sik Moon ),이배영 ( Bae Young Lee ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.5

A traumatic pulmonary pseudocyst is a rare complication of blunt thoracic trauma. The clinical symptoms and signs are similar to other respiratory diseases, such as pulmonary tuberculosis. Therefore, a trauma history with the resulting radiologic and clinical findings is important for making a diagnosis. A 26-year-old male was admitted to our hospital due to cough for 3 days. The chest x-ray revealed diffuse infiltrations and a cavitary lesion at the left lung. His left chest had hit a tree as a result of motorcycle accident one day before admission. Initially, it was assumed that his symptoms and chest X-ray might be due to a tuberculosis infection. However, bronchoscopy revealed old blood clots at both lungs, particularly in the left lower lobe bronchus. A transbronchial lung biopsy showed alveolar hemorrhage. A traumatic pulmonary pseudocyst was diagnosed from his trauma history and these findings. Computed tomography of the chest performed 4 months later showed regression of the cavitary lesion.

증례 : 호흡기 ; 임산부에서 발생한 원발성 폐암 1예

고선혜 ( Sun Hye Ko ),강현희 ( Hyeon Hui Kang ),임선미 ( Sun Mie Yim ),황유미 ( You Mi Hwang ),지은혜 ( Eun Hye Ji ),오유석 ( You Suk Oh ),이상학 ( Sang Haak Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.1

A 36-year-old primivida, at 29 weeks of pregnancy with no smoking history, was admitted to the hospital complaining of cough for 3 days. Chest X-rays revealed atelectasis of the right upper lobe, and a transbronchial Lung biopsy confirmed primary Lung adenocarcinoma. After consulting with obstetricians and neonatologists, we wanted to deliver the child and treat the mother with chemoradiotherapy. But as she was adamantly opposed to treatment until fetal Lung maturation was complete, we planned to delay the birth until 34 weeks, deliver the baby by caesarian section, and then treat the mother. However, maternal hypoxia and fetal distress resulted in an emergency delivery at 30 weeks. After delivery, we treated the mother`s brain metastases with radiation therapy and systemic cisplatin-pemetrexed, but she deteriorated and expired 95 days after the diagnosis. Lung cancer during pregnancy is a rare disease and raises many medical and ethical issues in deciding the best course of therapy. We describe our clinical approach and review the potentially challenging features of managing a pregnant patient with Lung cancer. (Korean J Med 2012;82:85-89)