• Title/Summary/Keyword: 환자의 접근

Search Result 959, Processing Time 0.032 seconds

Clinical managements of implant periapical lesions: a report of three cases with five to twelve years of follow-up (임플란트 근단 병소의 임상적 접근 방법: 5 - 12년간의 증례 보고)

  • Kim, Hyun Ju;Park, Se Hwan;Chang, Beom-Seok;Um, Heung-Sik;Lee, Jae-Kwan
    • Journal of Dental Rehabilitation and Applied Science
    • /
    • v.31 no.2
    • /
    • pp.150-157
    • /
    • 2015
  • The purpose of this report is to suggest clinical managements of implant periapical lesions by presenting three clinical cases managed by either the infected form or the inactive form with the follow-up period of five to twelve years. One patient with no clinical symptom was regarded as inactive form. Two patients having pain were regarded as infected form and have been under the systemic antibiotic therapy. In one patient, the symptom subsided and the size of radiolucent lesion decreased. However, the other patient showed increased size of lesion causing the implant unstable, which leaded to remove the implant and to replace it. There was neither additional increase of the lesion nor functional problem for all three. It is important to detect implant periapical lesion in early stage before jeopardizing the stable implant and manage properly using systemic antibiotic therapy and surgical approach if needed, depending on infected form and inactive form.

Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
    • /
    • v.85 no.3
    • /
    • pp.661-667
    • /
    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Delayed Bilateral Common Femoral Pseudoaneurysm after Percutaneous Access with Interventional Management: A Case Report (경피적 접근을 통한 시술 후에 발생한 지연성 양측 총대퇴 가성동맥류 및 인터벤션 치료: 증례 보고)

  • Sang Hoon Lee;Doo Ri Kim;Jeong Sub Lee;In Chul Nam;Su Yeon Ko
    • Journal of the Korean Society of Radiology
    • /
    • v.84 no.3
    • /
    • pp.705-712
    • /
    • 2023
  • Common femoral artery pseudoaneurysm is a potentially serious complication of peripheral angiography. There have been few prior reports of simultaneous pseudoaneurysm in both common femoral arteries after percutaneous access. Here we report the case of a 58-year-old male patient who presented with phlegmon or abscess a few days after bilateral femoral access, after which newly developed bilateral femoral pseudoaneurysm with wide neck was observed on CT angiography 2 months after infection treatment. Because the patient refused surgery for pseudoaneurysm, a stent-graft was inserted in the left side, and percutaneous thrombin injection under US guidance with balloon occlusion was performed for the right side. Most pseudoaneurysms occur immediately after the causative procedure. However, there have been some cases in which pseudoaneurysms may occur several weeks or months later; it is therefore necessary to check the risk factors and to carefully observe the hemostasis site.

Prevalence and Management of Venous Rupture Following Percutaneous Transluminal Angioplasty in Dysfunctional Arteriovenous Access: A Comparative Study of Primary Patency Rates with Non-Ruptured Access Circuits (동정맥루 기능 부전에서 경피적 혈관성형술 후 발생한 정맥 파열의 유병률 및 관리: 파열되지 않은 혈관과의 일차 개통 비교 연구)

  • Yoon Soo Park;Seung Boo Yang;Chae Hoon Kang;Dong Erk Goo
    • Journal of the Korean Society of Radiology
    • /
    • v.85 no.4
    • /
    • pp.746-753
    • /
    • 2024
  • Purpose This study aims to evaluate the incidence and management of venous ruptures after percutaneous transluminal angioplasty (PTA) for dysfunctional arteriovenous (AV) access. Materials and Methods From January 1998 to December 2015, 13506 PTA, mechanical thrombectomy, and thrombolysis procedures were performed in 6732 patients. The venous rupture rate following PTA was obtained, and access circuit primary patency (ACPP) was compared according to the etiology (PTA, thrombotic occlusion, and treatment type) of the venous rupture present. Results Venous rupture developed in 604 of the 13506 procedures. Venous ruptures were more frequent in female, AV graft cases, and in cases accompanied by thrombosis. Balloon tamponade was performed in 604 rupture cases, and stents were deployed in 119 cases where contrast extravasation and flow stasis persisted. ACPP was significantly better in the non-ruptured AV access circuits than in the ruptured group. However, AV access type and thrombosis was not associated with primary patency. In ruptured cases, ACPP is 8.4 months for prolonged balloon tamponade and 11.2 months for bare-metal stent insertion, showing statistically significant difference. Conclusion Balloon tamponade and bare-metal stent placement are effective treatment for PTA-induced venous ruptures. In particular, stent placement showed a similar ACPP to that of non-ruptured AV access circuits.

CONSERVATIVE APPROACH OF IATROGENIC ROOT PERFORATION (IATROGENIC ROOT PERFORATION의 보존적 접근)

  • Baik, Byeoung-Ju;Jeon, So-Hee;Park, Jeong-Yeol;Kwon, Byoung-Woo;Kim, Jae-Gon;Lee, Yong-Hoon
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.31 no.1
    • /
    • pp.59-65
    • /
    • 2004
  • Root perforations that result in a communication of the root space with the periodontal tissues occasionally occur during endodontic procedures. They may be induced iatrogenically. Successful treatment depends mainly on immediate sealing of the perforation and prevention of infection. Several factors affect the achievement of these goals, most important of which are time of occurrence, size and location of the perforation. Identification of root perforations is possible by direct observation of bleeding, radiography and an apex locator. Perforation defects may be repaired by nonsurgical or surgical techniques. We report two cases of root perforation. One was treated by glass ionomer, other was treated by composite resin with calcium hydroxide.

  • PDF

A Review of Spatial Neglect: Types, Theories, Neuroanatomy, Assessments and Treatment (편측 공간무시에 관한 고찰: 유형 및 이론, 해부학적 영역, 평가와 치료)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
    • /
    • v.6 no.1
    • /
    • pp.11-23
    • /
    • 2017
  • Spatial neglect is a neurological disorder following stroke, a lesion that usually affects the right hemisphere, fail to process or attention on the contralateral side of body and space. Functional neuroimaging studies report that spatial neglect is associated with lesions of large middle cerebral artery, perisylvian network and attention network. Spatial neglect is associated with a poor outcome. For optimal diagnosis and intervention, Types and theories of spatial neglect should be considered, in addition to clinical assessment with the conventional test and functional test. The treatment for spatial neglect could be consist of top-down approaches and bottom-up approaches. Recent trends in rehabilitation intervention for spatial neglect have reported prism adaptation.

The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
    • /
    • v.52 no.1
    • /
    • pp.33-39
    • /
    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

Effect of Physical Environment of Hospital on Customer' Satisfaction and Worth of Mouth, Revisit Intention (병원의 물리적 환경이 고객만족과 구전, 재방문 의도에 미치는 영향)

  • Kim, Jin-Sae
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.13 no.10
    • /
    • pp.4645-4652
    • /
    • 2012
  • Recently the demand for hospital care increased competition and a variety of new and expansion is a real situation that faced with a situation. These factors, in reality, the importance of the physical environment of the hospital soon for the hospital's survival and development, as well as the native functionality of the hospital to gain the core a competitive edge is being evaluated as a core competence. therefore this study aims to examine the effect of the physical environment of medical institutions on visits in patients satisfaction, worth of mouth and revisit intention. Some useful strategic materials derived from this study could be considerably useful to the managers of medical institutions. The results of this study are summarized as follows. First, the key elements which can decide the quality of the physical environment of medical institutions are accessibility, cleanness and convenience. Second, the perceived physical environment makes a positive influence on visits in patients satisfaction. Third, the more satisfaction the customers can perceive, the higher rises the worth of mouth. Fourth, the more satisfaction the customers can perceive, the higher rises the revisit intention.

The Effect of Physical and Psychological, and Social factors on Health Promotion Behavior among the stroke patients (뇌졸중환자의 신체적, 정신적, 사회적 요인이 건강증진행위에 미치는 효과)

  • Kim, Eun-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.16 no.12
    • /
    • pp.8525-8534
    • /
    • 2015
  • The purpose of this study was to investigate relations among the Health Promotion Behavior, Physically, Psychological, and Social factors of the stroke patients. The subjects include the patients that were Stroke was diagnosed and being admitted to hospital. The data of total 223 stroke patients were used in analysis. Collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation, and Structural Equation Analysis. As a result, The higher medical support health promotion behavior scores were higher. Health Promotion Behavior had correlations with the subjective health state(r=.56, p=.000), family support (r=.68, p=.000), medical support(r=.65, p=.000), Fatigue(r=.27, p=.004), and behavioral intentions(r=.75, p=.000). Factors Affecting Health Promotion Behaviors of the Stroke patients Physically factors of(${\beta}$=-.156, p=.014), Psychological factors of subjective health(${\beta}$ =.283, p=.001), behavioral intentions((${\beta}$=.362, p=.000), Social factors such as family support(${\beta}$=.219, p=.010), the medical support(${\beta}$=.246, p=.004) was found to be significant influence factors. In conclusion, health promotion behavior in stroke patients is subjective health, behavioral intentions, a family support. The higher medical support health promoting behavior appears score was found to be highly Psychological factors and social factors are important factors in promoting healthy behavior. Therefore, psychosocial personalized approach to maintaining the stroke health promotion, health promotion action program itdaneunde be used as basis for relapse prevention is significant.

Nasopharyngeal Cancer in Patients Under Thirty Years of Age (30세 이전에 발생한 비인강암의 임상적 고찰)

  • Ahn Ki Jung;Chang Eun Ji;Lee Hyung Sik;Moon Sun Rock;Seong Jin Sil;Kim Gwi Eon;Suh Chang Ok;Kyu John Juhn
    • Radiation Oncology Journal
    • /
    • v.8 no.2
    • /
    • pp.183-188
    • /
    • 1990
  • Between January 197l and December 1987, 113 patients with nasopharyngeal cancer (NPC) were treated by radiation therapy with or without chemotherapy in the department of Radiation Oncology, Yonsei University Hospital. There were 19 patients under thirty years of age. The histology was undifferentiated carcinoma in $68\%$ of the younger patients as compared to $47\%$ of the older patients. Sex, stage, initial symptoms and treatment modalities differed little from those of older patients. In younger patients, the initial complete response rate was $79\%$ as compared to older patients with $54\%$, distant metastases were more common and the overall five year survival rate was not significantly different between the two age groups ($33.7\%$ for the young vs. $37.4\%$ for the old). The five year survival rates for stage III and IV were $60.0\%$ and $24.5\%$, respectively. Histologic subtype was not correlated with survival. The best survival was found only in patients who obtained a complete clearance of disease after radiation therapy.

  • PDF