• Title/Summary/Keyword: 고령환자

Search Result 468, Processing Time 0.028 seconds

Endoscopic Removal of Benign Endotracheal/Endobronchial Tumor (기도 내 양성 종양의 굴곡형 내시경하 절제술)

  • 문석환;왕영필;서종희;조건현;곽문섭;이선희
    • Journal of Chest Surgery
    • /
    • v.36 no.9
    • /
    • pp.699-702
    • /
    • 2003
  • Endoscopic removal is acceptable for the treatment of endotracheal/endobronchial mass, because it is less invasive in high-risk patients and a conservative procedure for benign tumors. Two benign tumors in the lumen of the trachea (pure lipoma) and in the intermediate bronchus (hamartoma) were completely eradicated by our procedures, which involved diathermic snaring and residual mass removal with biopsy forceps under the guidance of fiberoptic bronchoscopy. No tumor recurrence was evident after extended follow-up (6 years for endotracheal lipoma and 2.5 years for endobroncheal hamartoma). Our method is safe and less invasive for the patient and provides the surgeon with better view during procedure.

Smart room system for serious patient (중환자를 위한 스마트 병실 시스템)

  • Cha-Hun Park;Dae-Sung Chu;Jang-Hyeon Kim;Hyun-Do Jung;Hyeon-Woo Choo;Hee-Yong Lim;Hwi-Jae Kang
    • Proceedings of the Korean Society of Computer Information Conference
    • /
    • 2024.01a
    • /
    • pp.273-274
    • /
    • 2024
  • 최근 저출산 문제로 인한 노동인구의 감소로 노동력이 감소하며 인건비가 증대되고, 의료 기술의 발달과 고령화로 인해 병실의 수용 인원이 증가했다. 특히 중환자, 거동이 불편한 환자, 노인 환자와 같은 간병인의 도움과 의료 종사자의 지속적인 진료의 필요성이 증대되고 있다. 환자의 상태를 일정 시간마다 확인해야 하는 불편함, 간병인 고용의 필요로 기본적인 병원비와 인건비가 증가되고, 의료업계 종사자들의 부담도 늘어나는 추세이다. 따라서 이러한 문제를 해결하기 위해 중앙 관제실에서 환자의 상태를 실시간으로 확인하고 자동으로 병실을 관리하는 시스템을 도입하고자 한다. 정보를 실시간으로 전달함으로써 의료진의 부담을 줄이고 위기 상황에 즉각적으로 대응하며, 자동 병실 환경관리와 환자 편의를 위한 의료 환경을 지원하는 시스템을 제안한다.

  • PDF

Evaluation of root and root canal morphology of elderly Korean patients maxillary molars using cone-beam computed tomography (CBCT를 이용한 한국인 고령환자의 상악 대구치에서 치근 및 근관형태의 분석)

  • Lee, Tae-Yong;Kim, Mi-Yeon;Kim, Sun-Ho;Kim, Jeong-Hee
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.58 no.2
    • /
    • pp.95-102
    • /
    • 2020
  • Purpose:The aim of the present study was to evaluate the incidence of the second mesiobuccal (MB2) canal, root fusion, and C-shaped root canal configuration in the Korean maxillary first (MM1) and second (MM2) molars by analyzing cone-beam computed tomographic (CBCT) images. Materials and methods: Patients undergoing presurgical CBCT examination were included in the current study. The CBCT images of 1498 MM1 and 1742 MM2 from 1658 Korean patients were assessed to determine the incidence of a MB2 canal, the types of canal configurations, root fusion, and C-shaped root canal configurations. Further, the correlations between the incidence of MB2 canal and age, gender, and tooth position were analyzed. Results: The study population was relatively old (mean age: 66.1 years). The percentage of MB2 canals in MB roots was 60.1% and 28.0% in MM1 and MM2, respectively, with the most common configurations being Weine type III in MM1 and Weine type II in MM2. Additionally, the frequency of a MB2 canal decreased with age in both molars and was higher in men than in women in the MM1 only. Furthermore, root fusion was present in 2.3% and 26.2% of the MM1 and MM2, respectively, whereas C-shaped root canals were observed in 0.4% and 2.7% of the MM1 and MM2, respectively. Conclusion: The MB2 canal was found more frequently in the MM1, whereas root fusion and C-shaped root canals were both seen more frequently in the MM2.

Risk Factors of Redo-valve Replacement (판막재치환술의 위험인자)

  • 최강주;조광현;김성룡;이상권;전희재;윤영철;이양행;황윤호
    • Journal of Chest Surgery
    • /
    • v.35 no.11
    • /
    • pp.785-791
    • /
    • 2002
  • The results of reoperative valve replacement can be improved if appropriate analysis for the risk of reoperation was achieved. The purpose of our study was to analyze the results of reoperations for failure of bioprosthesis, and to define the risk factors in high-risk populations for reoperative procedures. Material and Method The series of 46 consecutive patients who had undergone first reoperative replacement for failed bioprosthesis between 1993 and 2001 were reviewed retrospectively. Mean age was 42 $\pm$ 12 years, mean body surface area was 1.52 $\pm$0.15 $m^2$. The reoperative procedure comprised of 36 MVR, 8 DVR, and 2 AVR. The first operation comprised of 2 DVR, 1 AVR, and 43 MVR. Factors which were choose to assess a predictor of results in reoperative valve replacement were sex, old age(>60 years), early age at first operation(<30 years), long interval between first and redo operation(.15years), poor NYHA functional class(>3), LV dysfunction(LVEF<45%), long operation time(>8hours), endocarditis, combined procedures, and renal insufficiency, Result : Overall mortality was 4.3%(2 cases). The risk factors that influenced postoperative complications and unexpected postoperative results were lower ejection fraction(p=0.012), older age(p=0.045), endocarditis(p=0.023), long operation time above 8 hours(p=0.027). There was no statistically significant factor influencing hospital mortality. Conclusion : No factor influenced the mortality. Better results could be achieved if reoferation was performed carefully in poor left ventricular function, old aged patient, and with endocarditis. Effort to shorten the operation time would be helpful on postoperative results.

Double Tension Band Osteosynthesis in Intra-articular Fractures of the Distal Humerus (AO type C) in Elderly Osteoporotic Patients (고령 환자의 상완골 원위부 AO-C형 골절에서 이중 강선 장력대 고정술)

  • Cheon, Sang Jin;Lee, Dong Ho;Goh, Tae Sik
    • Clinics in Shoulder and Elbow
    • /
    • v.16 no.1
    • /
    • pp.33-39
    • /
    • 2013
  • Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.

The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
    • /
    • v.39 no.8 s.265
    • /
    • pp.619-625
    • /
    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

Full mouth rehabilitation using removable prosthesis of patient with unstable mandible movements: A case report (불안정한 하악운동을 보이는 환자에서 가철성 의치 수복 증례)

  • Sohn, Dong-Hwan;Yi, Yang-Jin;Jo, Deuk-Won
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.58 no.1
    • /
    • pp.35-41
    • /
    • 2020
  • Patients with collapsed occlusal support and unilateral chewing show parafunctional mandibular movements, which can be complicated in older patients. Gothic arch tracing and split cast technique are used to confirm the deviation between centric relation and anterior habitual bite in patient who has oral dyskinesia and collapsed occlusion. Temporary denture as occlusal stabilization appliance was provided for stable occlusion and reproducible mandibular movement. Definitive denture was fabricated by lingualized occlusion concept.

Development of voice-enabled Gas timer using the S3F8S19 processor (S3F8S19 프로세서를 이용한 음성지원 가스타이머 개발)

  • Choi, Young-Gyu
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
    • /
    • v.8 no.6
    • /
    • pp.551-555
    • /
    • 2015
  • Dementia of the country due to the aging population of 59 thousand people has reached serious territory. To increase the number of future dementia doubled every 20 years until 2050, in 2020 about 84 thousand people, about 127 thousand people in 2030, 2050 are estimated at 271 thousand people. If you have a gas stove when using dementia patients at home, Voice Support breaker is required in a fire can automatically block the gas valve because of a risk. In this paper, we develop a gas-timer demented patients using S3F8S19 8bit processor to use the gas safely.

Effect of Conditioning Regimen Intensity on Cytomegalovirus Infection and Related Risk Factors Analysis in Allogeneic Hematopoietic Stem Cell Transplantation (동종조혈모세포이식에서 거대세포바이러스 감염에 미치는 전처치요법 강도의 영향과 관련위험인자 분석)

  • Lee, Hye-Min;Heo, Yoon-Jeong;Im, Hyun-Jeong;Chung, Seon-Young;In, Yong-Won;Jung, Chul-Won;Lee, Young-Mee;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
    • /
    • v.22 no.2
    • /
    • pp.123-130
    • /
    • 2012
  • 거대세포바이러스(Cytomegalovirus; CMV) 감염은 동종조혈모세포이식 환자의 주요 사망원인 중 하나이다. 용량감소전처치(Reduced-intensity conditioning; RIC)를 이용한 조혈모세포이식은 골수억제전처치(Myeloablative conditioning; MAC)에 비해 골수억제 및 면역억제가 적으므로 CMV 감염 발생율을 감소시킬 것이라 예상되었으나 예방적 면역억제요법, T세포 제거 약제의 사용 등으로 서로 상이한 결과가 보고되고 있다. 2007년 1월부터 2009년 12월까지 총 141명의 환자(MAC 113명, RIC 28명)가 동종조혈모세포이식을 받았으며, CMV 감염은 MAC 62.8%, RIC 57.1% (p = 0.310), CMV 질환은 각각 12.4%, 14.3% (p = 0.785)에서 발생하였다. CMV 감염/질환 발생빈도와 CMV 항원 혈증검사 지속기간, 초기/최고치, 생존율은 두 군간 유의한 차이가 없었다. CMV 감염 위험인자에 대한 다변량분석 결과, 환자가 고령일수록(HR 1.024, 95% CI 1.002-1.045; p = 0.031) 또는 grade 2 이상의 급성 이식편대숙주병이 발생한 경우에(HR 1.849, 95% CI 1.031-3.315; p=0.039) CMV 감염 발생 위험율이 유의하게 높았다. 결론적으로, 전처치요법 강도에 따른 CMV 감염의 발생빈도와 발현양상의 차이는 없었으나, 고령이거나 grade 2 이상의 급성 이식편대숙주병이 발생한 환자의 경우 CMV 감염 발생과 유의한 연관성을 보였다. 이상과 같은 결과에 비춰 봐서 CMV 질환이 대부분 이식 100일 이후에 발생한 점을 고려할 때, 이식 후 CMV 감염 발생 시 ganciclovir 선제요법과 함께 이들 환자들에게 지속적인 모니터링을 실시하는 것이 필요할 것으로 사료된다.