• Title/Summary/Keyword: 임상 경과

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A statistical study of the foreign bodies in the food and air passages (식도 및 기도이물의 통계적 고찰)

  • 박근목;우영태;김은우;박해수
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.9.2-9
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    • 1977
  • A Statistical study was carried out on 64 cases of the foreign bodies in the food and air passages, who visited the Dept. of Otolaryng. of Korea General Hospital from Jan. 1971 to Dec. 1976. The following results were obtained. 1. The total number of foreign bodies were 64 cases, which is approximately 0.69% of the total number of new patients who visited the out patient department during the same period. Among them 55 cases were foreign bodies in the food passage and 9 cases were foreign bodies in the air passage. The ratio between the food and air passages was about 6.1 : 1. 2. The frequently encountered foreign bodies in the esophagus were coin, bone, meat and food particle in order. Bean and peanut were male and 31 case the most frequent foreign bodies in the air passage. 3. In sex distribution, 33 cases were male and 31 cases were female, and the ratio between male was 1.1:1. 4. In the age distribution, 35 cases (54.7%) of all foreign bodies were under 5-year-old, especially coin was 96.2%. 5. The most prevalent site of lodgement in the food passage was the 1st esophageal narrowing, which corresponds to 69.1%. 6. In duration of lodgement, 38 cases (69.1%) of foreign bodies in the food passage were removed within 24 hours, and the longest duration was 90 days. 7. Almost all of the foreign bodies in the food and air passages were removed under local or no anesthesia by esophagoscopy, laryngoscopy.

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Effect of Vegetal Complex Raw Food on Plasma Glucose and Lipid Composition in High Fat Diet-induced Diabetic Rats (식물류를 이용한 생식용 천연복합식품이 고지방 식이에 의한 당뇨병 유발쥐의 혈청 glucose함량 및 지질구성에 미치는 영향)

  • Lee Eun;Lee Mi-Kyung;Kim Pan-Gu;Kim Soo-Kyung;Lim Sang-Cheul
    • Korean Journal of Plant Resources
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    • v.18 no.2
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    • pp.270-278
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    • 2005
  • This experiment was conducted to develop and design a product that is convenient and helpful to both patients and ordinary people who want to maintain their health. In this experimentation, the experimental rat have been given with high fat food to induce Diabetes. Organic brown rice was given as their main energy source and natural complex food, most of materials were freeze-dried, was given to observe its effects on their glucose amount in the plasma. The results are as follows. During 28 days of basal diets, as observing their weight variations, normal group gained weights, but the natural complex food(NCF) groups lost their weights. As comparing the amount of neutral fat levels in the plasma between the diabetes group who just had basal group and one who had NCF, group with NCF groups' level was much lower than the other group who just had basal food. As comparing total cholesterol levels in the plasma, with diabetes group with basal food, $50\%$ and $100\%$ NCF groups' levels were lowered than that group. Regarding HDL-cholesterol level, all NCE groups had around 30mg/dl and there were not much fluctuation among groups. As for LDL-cholesterol level, the $100\%$ NCF group had the lowest level and showed almost the same as the normal group. The amounts of the glucose in the plasma were lowered in all NCF groups. Among those NCE groups, $100\%$ NCF group had 120mg/dl to reach almost the same as the normal group.

Case Report : Non-surgical Treatment of Inferior Alveolar Nerve Injury as a Result of Overinstrumented Root Canal Treatment (근관 충전제의 과충전에 의한 하치조 신경손상에 관한 비수술적 치료 증례)

  • Bae, Kook-Jin;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Cho, Young-Gon;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.199-205
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    • 2011
  • During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

Sleep Paralysis in Schizophrenia and Mood Disorder (정신분열병과 기분장애에서의 수면마비)

  • Park, Jae-Hong;Yang, Chang-Kook
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.115-121
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    • 2002
  • Objectives: Although sleep paralysis (SP) has been known as one of the symptoms of narcolepsy, recently it has become recognized as occurring frequently in the general population. However, the prevalence of SP and its associated factors in patients with major psychiatric disorders remain unknown. This study investigated the prevalence of SP and a variety of associated experiences in those patients. Methods: The subjects were 160 psychiatric patients and 143 age- and sex-matched controls. The Korean version SP questionnaire as well as the Sleep-Wake Schedule, Epworth Sleepiness Scale and Insomnia Severity Index were administered to all the subjects. The patients were referred from Dong-A University Hospital and consisted of 74 diagnosed as schizophrenia (47.7%), 26 as bipolar disorder (16.8%) and 55 as major depression (35.5%). Results: Nearly 42% of the patient group and 39% of the control group had experienced at least one episode of SP in their lifetime, with no significant difference between the groups. However, the patient group had experienced SP more frequently than the control group. Among all subjects, no gender difference in SP incidence was found. The peak age of onset was in the range of 16-25 years for both groups. Over eight tenths of both groups reported hallucinations and over seven tenths of both groups experienced fear accompanying SP. Conclusion: This study shows that there is no difference in the lifetime prevalence of SP between psychiatric patients and the general population, whereas frequency of SP experience is higher in psychiatric patients. Terrifying hallucinations and fearful feelings frequently accompany SP in both groups.

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Clinical Application of Nasal Intermittent Positive Pressure Ventilation with Bi-level Positive Airway Pressure(BiPAP) (기도 이중 양압(BiPAP)을 이용한 비강 간헐 양압환기의 임상적 적용)

  • Cho, Jae-Youn;Lee, Sang-Youb;Lee, Sang-Hwa;Park, Sang-Myun;Suh, Jung-Kyung;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.723-730
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    • 1995
  • Background: Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation, chronic obstructive pulmonary disease(COPD), and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP). Bi-level positive airway pressure(BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration. The device is similar to the positive pressure ventilator or pressure support ventilation. Method and purpose: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. Results: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) $PaO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01). $PaCO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. Conclusion: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

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A Canine Model of Tracheal Stenosis Using Nd-YAG Laser (Nd-YAG laser를 이용한 기관협착 동물모델의 개발)

  • Kim, Jhin-Gook;Suh, Gee-Young;Chung, Man-Pyo;Kwon, O-Jung;Suh, Soo-Won;Kim, Ho-Joong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.54-61
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    • 2002
  • Background: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. Methods : Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. Results : Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. Conclusion : The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.

A Case of Disseminated Coccidioidomycosis Involving Lung and Skin in Patient with Diabetes Mellitus and Iatrogenic Cushings Syndrome (당뇨와 의인성 쿠싱 증후군 환자에서 폐와 피부에 병발한 콕시디오이데스 진균증)

  • Han, Seung Yong;Kim, Cheol Hong;Son, Kwang Pyo;Kim, Jin Kyung;Byun, Hyeon Woo;Kim, Young Soon;Jeong, In Kyung;Woo, Heung Jeong;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Eil Seong
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.399-403
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    • 2005
  • Coccidioidomycosis is caused by a dimorphous fungus, Coccidioides, which consists of two species, C. immitis and C. posadasii. Although these organisms are genetically distinct and do not exchange DNA, they appear identical phenotypically and the disease or immune response to the organisms is also identical. Coccidioides grows as a mycelium in the soil and is mainly found in Southwestern United States, northwestern Mexico, and Argentina. An infection usually results from inhaling the spores of the fungus in an endemic area. Patients with a localized infection and no risk factors for complications often require only a periodic reassessment to demonstrate the resolution of the self-limited process. However, patients with extensive spread of infection or high risk of complications as a result of immunosuppression or other preexisting factors require a variety of treatment strategies such as antifungal therapy, surgical debridement, or both. Korea is not endemic area of a coccidioidomycosis. We report a case of disseminated coccidioidomycosis involving the lung and skin, which was detected incidentally after sunburn in a 69 year-old Korean male with diabetes mellitus and iatrogenic Cushings syndrome, with a review of the relevant literature.

Difference in Protein Markers According to the Survival of Sepsis Patients using Protein Chips (패혈증 생존 및 사망 환자 혈장에서 단백질 칩을 이용한 분석의 차이)

  • Park, Myoung Ok;Lee, Heui Young;Son, Hee Jung;Sung, Ji Hyun;Lee, Seung Joon;Lee, Sung Joon;Ha, Kwon Soo;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.41-45
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    • 2006
  • Background; Several clinical scoring systems are currently being used to predict the outcome of sepsis, but they all have certain limitations. Therefore, we sought to identify the proteomic biomarkers, with wsing proteomic tools, that differed according to the outcome of sepsis patients. Methods; Upon admission to the ICU, blood samples were obtained from the 16 patients with sepsis who were enrolled in this study. Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI -TOF MS) was used to identify the markers that could predict the outcome of sepsis. Results; We found six peaks, by using cation and anion chips, that statistically differed between those patients who died and those who survived. Conclusion; The biomarkers we found by using proteomic tools may help predict the prognosis and also plan the treatment of sepsis.

Factors Associated with Early Death in Patients with Community-Acquired Pneumonia (지역사회획득폐렴에서 조기 사망과 관련된 인자)

  • Park, Hun-Pyo;Seo, Yong-Woo;Lee, Jeong-Eun;Kim, Young-Ho;Jang, Young-Yun;Park, Soon-Hyo;Seo, Chang-Kyun;Jeon, Young-June;Lee, Mi-Young;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.607-613
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    • 2005
  • Background : Early death is an important problem associated with the management of community-acquired pneumonia. However, there is little information on the risk factors associated with it. The aim of this study was to identify the factors associated with early death in community-acquired pneumonia patients. Methods : From January 1999 to July 2004, 1,487 adult patients with community-acquired pneumonia who were admitted to the pulmonary department via emergency center were examined. Early death was defined as those who died within 2 days of hospitalization. The clinical and laboratory aspects of the patients who died early (n = 30) were compared with those of an age and gender matched control population (n = 60). Results : In the early death group, respiratory rate, heart rate, and blood urea nitrogen (BUN) were significant higher (p < 0.05 for all), while the arterial pH, systolic pressure, and $PaO_2$ were significant lower (p < 0.05 for all) than the control. The independent factor significantly associated with early death was tachypnea (OR, 7.049). Conclusion : The importance of an early clinical assessment in emergency center with community-acquired pneumonia needs to be emphasized in order to recognize patients at risk of early death.

EFFECT OF ADMINSTRATION METHOD OF FLUMAZENIL ON THE PLASMA CONCENTRATION AND THE REVERSAL OF SEDATION INDUCED BY MIDAZOLAM (Flumazenil의 투여 방법에 따른 혈장내 농도와 midazolam에 의해 유도된 진정 상태의 환원 효과)

  • Park, Seong-Kyu;Lee, Sang-Ho;Lee, Chang-Seop;Lee, Nan-Young;Oh, You-Hyang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.499-508
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    • 2005
  • The purpose of this study were to evaluate the effect on the reversion of sedation induced by midazolam with flumazenil and to determine the plasma concentration of flumazenil according to the method of administration. Intranasal and intravenous flumazenil were administered to sedated health volunteers aged from 23 to 25 years, in doses typical of those used clinically to induce sedation with midazolam and for reversal with flumazenil. Objective assessment for degree of sedation and vital signs, plasma concentration were made for 2 hours period. 1. Systolic and diastolic blood pressure, $SpO_2$ were not changed by adminstration of flumazenil in sedated subject with midazolam, but pulse rate was increased temporarily. 2. Flumazenil showed the reversal of the sedative effect induced by midazolam regardless of administration methods. But intravenous administration showed more effect on the degree and the duration of reversion than intranasal administration with the exception of on set time. 3. Peak plasma concentration of flumazenil administered by intranasal route reached after 2 min and that of flumazenil administered by intravenous route was 4 min. Thus uptake of flumazenil did not showed any difference in accordance with the adminstration route. 4. Administration of flumazenil resulted in the temporary increase of midazolam plasma concentration.

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