• Title/Summary/Keyword: 외래처치

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Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor (족관절 내과 절골술 및 대형신연기를 이용한 제3형 거골 경부 골절의 치료 결과)

  • Park, Sung Hae;Lee, Jun Young;Lee, Jung Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.45-51
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    • 2019
  • Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.

Video-Assisted Thoracoscopic Lung Volume Reduction Surgery in Severe Emphysema -A Case Report (폐기종 환자에서의 흉강내시경을 이용한 폐용적 감축술 -1례 보고-)

  • Lee, Du-Yeon;Jo, Hyeon-Min;Mun, Dong-Seok
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.827-832
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    • 1997
  • Lung volume reduction surgery(LVRS) has recently been advocated as an alternative or a bridge to lung transplantation for patients with evere dibbling emphysema. This procedure is a palliative treatment performed to alleviate the dyspnea of patients with emphysema and improve performance in the activities of daily living. The rationale of lung volume reduction for generalized emphysema is that the removing of the diseased and functionless lung may improve the function of remaining, less diseased lung. The factors critical to the success of LVRS are careful patient selection, accurate localization of target areas, meticulous anesthetic and operative technique, and intensive postoperative support. We have experienced a case of severe emphysema in a 59-year-old male patient. After selection process and pulmonary rehabilitation, the patient was treated with video-assisted thoracoscopic LVRS and the post-operative course was uneventful.

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DENTAL TREATMENTS OF THE CHILD WITH LOWE SYNDROME : A CASE REPORT (Lowe syndrome 환아의 치과적 치료 : 증례보고)

  • Ju, Chan-Hee;Kim, Seon-Mi;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.161-165
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    • 2012
  • Lowe syndrome, also known as oculocerebrorenal syndrome, is a rare genetic disorder involving eyes, kidney, brain and musculoskeletal system, and occurs predominantly in males. The patient with Lowe syndrome is characterized with congenital cataracts, glaucoma, prominent forehead, thin and sparse hair, mental and growth retardation, muscular hypotonia, renal dysfunction, and metabolic bone disease. We have experienced a 10-year-old boy with Lowe syndrome who had poor oral hygiene and trouble for teeth brushing. To manage his behavior and systemic metabolic disorder, sedation was performed during dental care. Excessive calculus formation in this patient is caused by both medication and lack of ability to maintain oral hygiene. The dental management of those patients has to be focused on prevention due to difficulties in dental treatment and dangers of general anesthesia for the Lowe syndrome.

Parental response, recognition and management about fever in children (소아의 열에 대한 부모의 반응과 이해 및 처치)

  • Kim, Eugene;Hur, Jae Kyun
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.55-61
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    • 2007
  • Purpose : Fever, the most common presenting symptom in pediatric clinics, has been believed to be a dangerous symptom by many parents. Proper recognition about fever will relieve unnecessary anxiety of parents and help them understand the course of the disease. Our objectives of this study were to investigate current parental recognition about fever and to compare these results with those described in 1992. Methods : Between May and July 2006, we questioned caregivers who visited the pediatric outpatient clinic in St.Paul hospital. The questionnaire consisted of 19 items asking about recognition, attitude and management of fever. Results : A total of 136 caregivers were interviewed. Compared with 10 years ago, there were no significant improvements in misconception about fever. Many caregivers (61%) had wrong information about a definition and the way to measure body temperature. There were still high concerns about febrile convulsion and brain damage from fever. Caregivers started treatment at the body temperature which actually needed no therapy. Conclusion : Parents were not aware that fever is just one of physiologic responses and has benefits, which led to unnecessary anxiety and treatment. This misconception has not been changed over the years. Pediatrician should inform parents that fever itself is not harmful and only rational reason for use of antipyretics is to relieve a discomfort of a febrile child. An educational interventions offered by pediatricians will be helpful for parents to have right attitude and understandings toward fever.

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SMITH-MAGENS SYNDROME (SMS) : A CASE REPORT (Smith-Magenis Syndrome (SMS) 환아의 증례 보고)

  • Kim, Eun-Young;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.341-347
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    • 2003
  • Smith-Magenis syndrome (SMS) is a clinically recognizable multiple congenital anomaly and mental retardation syndrome caused by an interstitial deletion of chromosome 17 p11.2. Physical features include short stature, characteristic facial appearance: flattened mid-face, down-turned mouth, prominent and often rosy cheeks; prominent jaw in older children and adults, chronic ear infections, hearing impairment, eye problems, including: strabismus (an eye which turns in or out) and myopia (nearsightedness), hoarse voice, short fingers and toes, heart defects or murmurs, problems related to the urinary system, scoliosis (curvature of the spine), an unusual gait (walking pattern), and decreased sensitivity to pain. Behavioral and developmental characteristics include speech delay and articulation problems, developmental delay, learning disability, mental retardation, hyperactivity, self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices, explosive outbursts, prolonged tantrums, destructive and aggressive behavior, excitability, arm hugging or hand squeezing when excited. This report is the case of a Korean 3-year-3-month old male with Smith-Magenis syndrome referred from local clinic for the treatment of dental caries. The patient was treated by physical restraint after prophylatic administration of antibiotic(Amoxacillin 50mg/kg).

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The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry (이중에너지 X-ray 흡수법을 적용한 근위 대퇴골 및 요추부 골밀도 검사의 상관관계 분석)

  • Han, Man-Seok;Cho, Dong-Heon
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.9
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    • pp.165-169
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    • 2012
  • To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine at age. It is based on 62 cases who visited the out-patient department. They were classified into three groups by age, group I (30~40 yr) and II (40~60 yr) and III (60~80 yr). Then we evaluated the average and the degree of correlation between the three groups and analyzed the correlation of the three sites according to the BMD result and T & Z-score through the t-test analysis. The results are listed below, first, if rise in age T-score is lower and over 60age occurred osteopenia, second, compared three groups, the correlation of BMD results was some of the highest between Lumbar spine and Proximal femur of T-score & Z-score. the correlation of BMD results is very high. It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

Sudden Deafness (돌발적난청)

  • 조중환;류태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.85.3-86
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    • 1976
  • Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

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The Effect of Abdominal Massage on Sleep Colonoscopy Subjects (수면 대장내시경 검진자에게 시행한 복부마사지의 효과)

  • Lee, Yun-Jeong;Je, Nam-Joo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.6
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    • pp.410-420
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    • 2019
  • The purpose of this study is to investigate the effect of abdominal massage, on abdominal bloating and the recovery of bowel movement after sleep colonoscopy. The study design is the time difference before and after the non-equality control. The subjects were 22 patients each in experimental group and control group who recieved sleep colonoscopy at the G hospital in C city, The data collection period was from June 1, 2018 to August 25, 2018, and the control group's data were first collected with time difference from the collection of experimental group's data to prevent the spread of the experiment. Data were analyzed using IBM SPSS 24.0 and tested by independent sample t-test, $x^2-test$ and Fisher's exact probability test to verify the homogeneity of general characteristics of the subjects. Shapiro-Wilk was used to verify the normality of the abdominal circumference changes in the experimental and control groups. Mann-Whitney U test was used to verify the pre-homogeneity of the abdominal circumference of the subjects. The experimental results were verified by Fisher's exact probability test, Friedman test and Mann-Whitney U test. These results suggest that the abdominal massage can be used as a nursing intervention after sleep colonoscopy by reducing the gas discharge time($x^2=19.75$, p<.001) and abdominal bloating($x^2=29.93$, p<.001).

DIFFERENT WAYS OF SURGICAL MANAGEMENT FOR CHILDREN WITH CONFOUND ODONTOMA IN THE MANDIBLE (아동의 하악골에 발생한 복합 치아종의 외과적 처치에 관한 증례보고)

  • Chung, Woo-Sung;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.3
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    • pp.499-506
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    • 1999
  • The odontoma is relatively a common benign odontogenic tumor and caused by overgrowth of odontogenic tissues. The recent classification by World Health Organization divides odontoma into 2 groups such as compound odontoma and complex odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. The etiology of odontoma is unknown and almost asymptomatic. So, it usually is found in routine radiographic examination, and most common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth. It can occurs almost anywhere in jaws. It is desirable that odontoma should be removed by surgical enucleation including follicle and surrounding soft tissues. Considering the age and behavioral cooperation of patient, the development of permanent dentition, the location of odontoma in jaw, the need for the concomitant operative dentistry, operation is performed in outpatient department with/without sedation or under general anesthesia with endotracheal intubation. In this case report, 2 patients with compound odontoma were treated by surgical enucleation including follicle and surrounding soft tissues. One patient, about 5 years old, was treated under general anesthesia and concomitant operative dentistry was performed. The other patient, about 11 years old, was treated under local anesthesia in outpatient department. In 2 cases, after 4 months, surgical defects were filled with new bone and normalization of eruption path of impacted permanent teeth was observed.

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Improvement of Patient Safety and Inspection Satisfaction by Developing Pretreatment Process System with the Patients Who Reserved CT Enhance Examination (CT 조영검사 예약환자의 전처치 프로세스 시스템 개발을 통한 환자안전 및 검사 만족도 향상)

  • Beom, Hyinam;Han, Jaebok;Song, Jongnam;Kim, Wook;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.10 no.1
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    • pp.29-37
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    • 2016
  • This study aims to improve the satisfaction level of the patient who undergoes CT contrast examination by developing and applying pretreatment process system, which not only can reduce the side effects caused by the test but also can help carry out the test smoothly. The subjects were 214 patients who booked CT contrast examination from January 2014 to February 2014 but could not carry out their test on schedule. We analyzed the reasons for the delay and conducted follow-up survey on them. We analyzed the usefulness of pretreatment process system by contemplating and developing pretreatment process system and applying it to the patients for whom follow-up survey was conducted from January 2015 to February 2015. The number of outpatients who came to the hospital form January to February 2014 was 2,846 and the number of patients who could not undergo the test was 214, accounting for 7.52% of the total. The specific reason for the delay includes 214 cases of unknown creatinine 98 with 120 minutes of average delay time, 40 cases of creatinine over 1.3(19%) with 30minutes of average delay time, 34 cases of past contrast media side effect 6% with 40 minutes of average delay time and 25 cases of lack of pretreatment such as fasting, etc. 11% with 120minutes of average delay time. The number of CT scan has been increasing ever since the development of CT and the frequency of using the contrast media is expected to increase. If we can employ pretreatment process system in order to effectively control the side effect of contrast media and help the CT contrast examination to be smoothly conducted on schedule, I'm sure we could improve the quality of our medical service and increase our patients' satisfaction who come to our CT scan room.