• Title/Summary/Keyword: 응급치료

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Recurrent Brain Abscess In Chronic Sinusitis : A Case Report (만성부비동염을 가진 환자에서 재발된 뇌농양 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.275-279
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    • 2018
  • A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

Treatment of Traumatic Vascular Injury (외상성 혈관 손상의 치료)

  • 장인석;최준영;김종우;이정은;이상호
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.590-594
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    • 2003
  • Vascular injury has been increased with popular outside activities. However there are only a few studies for vascular trauma. We intended to find out the relationships between the vascular trauma and its prognosis. Material and Method: Forty-four patients were diagnosed and operated on for vascular injury in the Gyeongsang National University Hospital from 1992. to 1999. We reviewed their chart and analysed their data retrospectively. We studied to causes, treatments, and prognoses of traumatic vascular injury. Result: The transfer time between accident place and emergency department was mean 3,5 hour, and the operation preparing time was 8.8 hours. Five cases required amputation of extremity. All amputation cases were combined with communited bony fractures. Thirty-eight cases had combined other injuries, and almost combined injuries were muscular and neurological damages, Conclusion: The optimal treatment plan for vascular trauma was prompt diagnosis and quick management. It may decrease amputation rate and post-traumatic complications. Therefore we must be carefully evaluated the multiple traumatic patients for early diagnosis of vascular injury and operate quickly in emergency status.

Aortic Root Replacement Using Aortic Homograft in Acute Bacterial Endocarditis One Case Report (심내막염 환자의 동종대동맥편을 이용한 대동맥 근부 치환술 - 1례 보고 -)

  • Im, Chang-Yeong;Lee, Heon-Jae
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.819-822
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    • 1997
  • Aortic valve replacement with aortic allograft has been considered a treatment of choice for aortic valve disease secondary to bacterial endocarditis because of its good homodynamic performance and higher resistance to infection. The aortic root replacement technique might be superior to the subcoronary allograft implantation technique with regard to aortic regurgitation. A 46 yea,rs old male patient had acute aortic regurgitation with progressing heart failure secondary to acute bacterial endocarditis. The patient underwent emergent aortic root replacement using 20 mm aortic allograft. At operation, right coronary cusp perforation and heavy calcification of commissure between right and left coronary cusp were observed. The patient recovered well and postoperative echocardiography demonstrated no aortic regurgitation. Inflammatory signs were subsided after 8 weeks of antibiotics therapy. Medically uncontrolled acute bacterial endocarditis was treated successfully by aortic root replacement using aortic homograft.

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Recent trend and surgical management for panfacial fracture (범안면골 골절의 최근 경향 및 수술개념)

  • Kim, Jin-Wook
    • The Journal of the Korean dental association
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    • v.54 no.10
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    • pp.811-819
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    • 2016
  • Panfacial fracture is extremely difficult to manage facial injuries but concomitant injuries and severe complications including facial esthetic and functional problems can make it harder. Thorough evaluation and closed co-work with other specialists is needed when reduction and fixation cannot be achieved quickly. Emergency bony support and soft tissue key suture provide the patients with airway integrity, hard and soft tissue vitality. A systemic treatment plan must be made by 3D CT image. This plan include airway management for surgery, sequence of reduction and fixation, approach method, soft tissue resuspension and reconstruction of lost tissue like inferior orbital wall, zygomaic buttress and soft tissue. From known to unknown structures, accurate reduction and fixation will provide proper occlusion, facial projection, width, hight and function. Consideration about facial retaining ligaments must be given to prevent soft tissue sagging.

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DENTAL MANAGEMENT UNDER GENERAL ANESTHESIA OF CHILDREN WITH HEMOPHILIA A AND HEMOPHILIA B (혈우병A와 혈우병B 환자의 전신마취 하 치과치료)

  • Kim, Ik-hwan;Park, Minji;Lee, Ko-Eun;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.2
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    • pp.102-105
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    • 2018
  • Hemophilia is an X-linked herediatry disorder. Hemophilia A is a defiency of factor VIII and hemophilia B (Christmas disease) is a deficiency of factor IX. The most widely used classification is based on plasma procoagulant levels, with people <1% factor defined as severe; 1 - 5% moderately severe; and >5% as mild. A 7 years old boy visited our clinic with chief complaint of impacted supernumerary tooth. This boy had severe hemophilia A. With the previous $ADVATE^{(R)}$ injection and factor VIII replacement, Extraction of supernumerary tooth was successfully done under General anesthesia. A 9 years old boy referred from local clinic for dental caries treatment. This boy had severe hemophilia B. With the preparation of $BeneFIX^{(R)}$ injection, dental treatment was done successfully under general anesthesia. It is often first detected by dental trauma. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. The treatment of the patients with either hemophilia A or hemophilia B involves the intravenous infusion to either control or prevent bleeding.

Interventional Treatment of Chemical Pleuritis and Hemothorax Caused by Iatrogenic Internal Jugular Vein Perforation after Central Venous Port System Implantation: A Case Report (중심정맥포트 삽입 후 의인성 속목정맥 천공에 의한 화학적 늑막염과 혈흉의 중재적 치료: 증례 보고)

  • Do Woo Kim;Young Hwan Kim;Ung Rae Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1459-1465
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    • 2020
  • The perforation of the intrathoracic internal jugular vein during the placement of an implantable central venous chemoport is a rare complication that is manifested by hemothorax or hemorrhagic shock. Furthermore, inappropriate instillation of a chemotherapeutic agent in the chemoport can cause chemical pleuritis, and the diagnosis of these complications prior to the instillation of chemotherapeutic agents and open thoracic surgery is mandatory. We report a patient with chemical pleuritis and hemothorax following an inappropriate instillation of a chemotherapeutic agent, through the perforated right internal jugular vein after placement of an implantable central venous chemoport. Treatment by embolization using coils and N-butyl cyanoacrylate, after percutaneous drainage, was successful.

Surgical Treatment of Traumatic Ventricular Septal Defect by Penetrating Chest Injury (흉부관통상으로 인한 심실중격결손의 치료)

  • 김시욱;한종희;강민웅;나명훈;임승평;이영;최시완;유재현
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.999-1002
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    • 2004
  • Thirteen year old boy who had been stabbed in his left chest by the knife was transferred to our department from a general hospital, because of the massive bleeding from the intercostal tube drainage. Chest X-ray showed homogeneous density in the left lung field. He was confused and his vital signs were unstable. He was moved into a operating room as soon as possible. After resuscitation, his lacerated left ventricle wound was sutured through median sternotomy. The interventricular shunt was detected with intraoperative transesophageal echocardiography. The traumatic ventricular septal defect was closed via left ventricle using Dacron patch. His postoperative course was uneventful, and he was discharged with small residual shunt.

Emergency Bilobectomy under the Extracorporeal Membrane Oxygenation Support for Pediatric Patient with Blunt Traumatic Bronchial Transection - A case report- (둔상에 의한 기관지 절단 환아에게 체외막형 산화기 보조하에 시행한 응급 이엽 절제술 - 1예 보고 -)

  • Chang, Won-Ho
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.804-807
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    • 2010
  • Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and. there were no thrormbotic complications. In conclusion, ventilatory SUpport using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.

Hybrid Procedure for Aortic Arch Repair: Arch Vessels Debranching with Supraaortic Revascularization Followed by Endovascular Aortic Stent Grafting (대동맥궁 대동맥류에서 Hybrid 수술적 치료)

  • Moon, Duk-Hwan;Chung, Cheol-Hyun;Kim, Hee-Jung
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.520-523
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    • 2009
  • Aortic arch aneurysm generally requires an urgent treatment due to the risk of catastrophic aortic rupture. However conventional surgery for aortic arch repair still carries significant risks of postoperative morbidity and mortality, especially in patients with old age. In an effort to correct the aortic pathology while minimizing the risks of complication, we performed a hybrid technique which comprises the off pump arch aortic stent grafting in an 86-old male patient with an aortic arch aneurysm.

Open Embolectomy of an Acute Pulmonary Artery Embolism after Pulmonary Lobectomy (폐엽절제술 후 생긴 급성폐동맥색전증에서 수술을 통한 색전 제거술)

  • Kim, Jae-Jun;Kim, Hwan-Wook;Wang, Young-Pil;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.433-436
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    • 2010
  • Acute massive pulmonary artery embolism after pulmonary resection is very rare, but has a high mortality rate. This is one of the most severe complications after pulmonary resection. Acute pulmonary artery embolism developed suddenly in a patient who underwent lobectomy and was recovering without complications. Because the patient’s condition was aggravated after conservative treatment, we did emergency open embolectomy which was successful. Hence, we report this case with a literature review.