• Title/Summary/Keyword: Alcoholic patient

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A Case Of Chronic Alcoholic Derogation (주상(酒傷) 치험 1례 보고)

  • Kim, Dong-Woo;Park, Chong-Hyeong;Han, Yang-Hee;Jun, Chan-Yong;Park, Se-Ki;Go, Seung-Hi;Lee, Chung-Jung-Hye;Go, Jae-Chul;Choi, You-Kyung;Park, Ji-Yun;Baek, Eun-Ki;Hong, Ui-Sil
    • The Journal of Internal Korean Medicine
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    • v.22 no.2
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    • pp.239-243
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    • 2001
  • Alcoholism is a chronic behavior disorder that disturbs the health, social, and economical functions by intaking alcohol repeatedly. Alcoholism includes some habituation, dependency, and addiction. It may be clinically silent or severe enough to lead to the rapid development of hepatic, renal and gastrointestinal failure. Alcoholism can also cause death. In this case, we administrated saenggangunbitang and sungjoocheonggantang to a patient suffering from alcohoism and its withdrawal symptoms. After administration of saenggangunbitang-sungjoocheonggantang medication, clinical symptoms, including liver function with diabetes mellitus and splenomegaly improved. saenggangunbitang-sungjoocheonggantang showed desirable effect on alcoholism symptoms.

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Investigating Research on the Degree of Frequency and Importance of Tasks for Framing the EMTs Occupational Description (응급구조사 직무기술서 작성에 따른 일의 요소별 빈도 및 중요도 조사 연구)

  • Kim, Tae Min;Kim, Hyo Sik;Yoou, Soon Kyu
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.199-212
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    • 2001
  • This research, aiming at analyzing the Emergency Medical Technicians' duties prior to establishing a baseline for question development in the national exams to qualify for the EMTs, investigated the importance and frequency per unit specified in the description with the EMTs to be subjects working on the task spot by means of questionnaires. The EMT duties were classified into 9 items like 1) the notification and response, 2) the scene size-up, 3) the patient assessment, 4) the emergency care, 5) the patient transport, 6) the duties at hospital clinics, 7) the operational management, 8) the receiving and responding to a call, 9) the self-development, and put the functional tasks into 52 items, describing the task elements into 177 items, and then questioned 112 EMTs working on the spot from July 21 through August 30, 2000, which showed the following results. 1) The distribution of subjects' career showed the highest rate with 33.9% for those who careered "less than a year", only 13.4% for those with more than 4 years and the highest rate with 43.8% for those who aged at 20-25. And 70.5% of all those who were questioned was the junior college graduates, 58.9% for those working at fire station and 29.5% working at hospital clinics. 2) Looking at the distribution of frequency and importance for each task element, questioning 'the patients main symptoms', 'accidental type', 'place of the patients identification' showed the highest rate in both frequency and importance in the field of "notification and response". 3) In the "scene size-up", identifying the patients showed the highest rate of frequency and importance, compared to other field of tasks, among which "identifying the patients' state" showed the highest rate of frequency (2.66) and importance (2.81). 4) In the "patient assessment", "identifying the patients" showed the high rate of frequency and importance in most elements of task, especially the importance showed the highest rate with 2.83 for the task of airway management and the cervical immobilization during "the primary assessment", and the frequency showed the highest rate for questioning the past case of the task of grasping the patients' history. 5) In the "emergency care", "the management of the heart attacked patients" and "the advanced cardiac life support" showed a high rate in the importance, whereas the frequency showed a very low rate. The high rate of frequency during the emergent task was the management of "musculoskeletal system injury patients" and of "the gastro-intestinal and urinary genital system injury patient support." In care of the patients with heart attack, the management of the airway showed the highest rate with 2.95, whereas the management of alcoholic abused patients and of dying patients, showed comparatively lower rate of assessment in the importance. The frequency of tasks showed the highest rate with 2.69 in the control of bleeding and the lowest with 0.47 in the management of abnormal delivery of child. 6) As to the patient transport, "the emergency transport" showed the highest rate with 2.74 and the unemergent transport with 2.55 in the importance, and the task importance at hospital showed the highest rate with 2.89 in managing the cardio-pulmonary resuscitation and with 2.60 in identifying the patient state. 7) Of all the tasks related with "operational task", the high importance was to "educate for the management of the first responder", but the frequency of tasks mostly showed a low rate and "receiving and responding to a call" showed relatively a high rate of importance and frequency. And related with "the self-development", "the health care management" and "the stress control" on working spot showed a high rate, but the frequency mostly showed a low rate.

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A study on Supply Extension Device of AED (AED의 보급 확대 방안에 관한 연구)

  • Koh, Jae-Moon;Kim, Young-Ho;Han, Sang-Hak
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.147-168
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    • 2005
  • It examined the doubt point which AED motive relates until now, the AED should have bought a life how, present address of our country site pre-hospital care, comparison it tried to observe the advanced nation instance back. Gist of this research the AED important cold region once compared to informed to how many cardiac arrest patient, against him the what kind of preparation wanted informing the necessary cold region. It soaks simultaneously but the AED motive is widely supplied distant in future and it is generality and it is feeble but it wanted doing one morning. The habit difference of an American who does of course meat diet mainly and a Korean is many and it compares in the United States and the cardiac arrest patient comparison occurs holds a point few. To become Western anger but and be caused by with thin dietary life, stanching bleeding cung, with the fact that the heart attack is increasing rapidly with the hyperextension. It is a talk which anyone it knows all. The major league most Choi huy Sub in condition will catch the ball which floats and the multi co-player and to collide when falling down, the medical device which is committed with emergency aid is AED motive. From the United States subway station and the shopping which are a public place on the baseball field outside the jar which it will drive, the museum and the school, easily there is it will be able to discover the AED from the court of justice back. The Pittsburg university the students per the individual $30 the core phyey were receiving the smallness lifestyle alcoholic beverage and a AED motive actual training with mercy of degree. From the United States distant in future the AED motive is sold even from the retail store and. From our country like this plan government offices temporary disposal education from from 119 fire fighters emergency structure company in fire fighting government employee and nursing must magnify a former enterprise rainy spell in summer multi temporary disposal education with the head which it will burn with the head. This plan in early rising will be able to become fixed in Korea it forecasts with the fact that. The research which it sees it leads and like the United States to some day become fixed even from our country to believe and suspicion it is not and in the people in approach ease one AED supply plan fire fighting government employees stand in the first and feed with the fact that must be positive at this enterprise they become.

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A Discovery of the Creative Healing Properties in the Unconscious of Alcoholics: From the Perspective of Analytical Psychology (알코올 중독에서 발견되는 무의식의 창조적 치유 활동: 분석심리학의 관점에서)

  • Kihong Baek
    • Sim-seong Yeon-gu
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    • v.39 no.1
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    • pp.129-183
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    • 2024
  • This study is an attempt to get closer to the psychological truth of alcohol addiction. After reviewing previous related studies, the experiences of Korean alcoholics were examined, encompassing both the conscious and unconscious aspects. In order to approach the unconscious, the researcher paid attention to the series of dreams that the patients reported, from the perspective of Jungian dream analysis. Working with dreams brought considerable benefits in increasing patient's involvement in the therapeutic process and fostering therapist-patient alliance. It also helped to understand patients' conscious and unconscious aspects further. The results were as follows. On the conscious level, patients showed a long-standing alienation from their true emotional needs, a lack of sufficient experience in genuinely expressing and being accepted with one's own emotion, resulting in the need for emotional re-experience, along with the intense longing for maternal affection. This also meant that they were in need for maternal re-experience, and at the same time, for the associated paternal re-experience. Furthermore, the researcher identified that certain powerful archetypal complexes had been activated in the patient's unconscious in response to their conscious situations, triggering the destructive shadows to emerge and exert a strong influence on their conscious lives. The series of reported dreams shows how the unconscious always properly and diligently compensates, modifying the perspective and attitude of the conscious and gradually opening the doors to healing, even for alcoholic patients. This indicates that the unconscious carries out a specific and consistent guidance role so the conscious can realize and adequately respond to it, and that it also provides the creative force for transforming the conscious life. These findings suggest that alcohol addiction is a psychological condition that can jeopardize one's life by allowing the powerful energy of the unconscious to penetrate the conscious, but at the same time, have the purpose and direction to urge the creative transformation of one's conscious life. From these results, it can be concluded that the first step towards true recovery is for the individual to turn their attention towards the psychological truth occurring within themselves. In this regard, the therapist's role is crucial. This also suggests that various attempts in the field of addiction treatment will blossom their real values when they contribute, directly or indirectly, to the development of one's self-awareness since as long as one continues to turn away from the psychological truth and persist in craving for false objects, their creative healing properties in the unconscious could rather have negative and destructive impacts on their life.

Arterio-Biliary Fistula as a Rare Life-Threatening Complication of Transjugular Intrahepatic Portosystemic Shunt: A Case Report (경경정맥 간내 문맥 정맥 단락술 후 드물게 발생하는 동맥-담관루: 증례 보고)

  • Ji Su Ko;Lyo Min Kwon;Han Myun Kim;Min-Jeong Kim;Hong Il Ha;Ji Won Park;Ji Young Woo
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.705-711
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    • 2022
  • A 46-year-old male with alcoholic liver cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for refractory ascites. On the 9th day after the procedure, he presented with melena and decreasing hemoglobin levels. Hemobilia due to fistula formation between the right intrahepatic bile duct and right hepatic artery was suspected on computed tomography. Angiography revealed a fistula of the small branches of the hepatic segmental arteries, and right intrahepatic bile duct was confirmed; embolization was successfully performed with a coil for the eighth segmental hepatic artery, a glue-lipiodol mixture for the fifth segmental hepatic artery, and gelfoam slurry for the right anterior hepatic artery. However, 2 days after embolization, the patient died owing to aggravated disseminated intravascular coagulopathy. When gastrointestinal bleeding occurs after TIPS, careful evaluation is immediately required, and hemobilia should be considered.

Splenic artery steal syndrome after liver transplantation - prophylaxis or treatment?: A case report and literature review

  • Sofia Usai;Marco Colasanti;Roberto Luca Meniconi;Stefano Ferretti;Nicola Guglielmo;Germano Mariano;Giammauro Berardi;Matteo Cinquepalmi;Marco Angrisani;Giuseppe Maria Ettorre
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.386-394
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    • 2022
  • Splenic artery steal syndrome (SASS) is a cause of graft hypoperfusion leading to the development of biliary tract complications, graft failure, and in some cases to retransplantation. Its management is still controversial since there is no universal consensus about its prophylaxis and consequently treatment. We present a case of SASS that occurred 48 hours after orthotopic liver transplantation (OLTx) in a 56-year-old male patient with alcoholic cirrhosis and severe portal hypertension, and who was successfully treated by splenic artery embolization. A literature search was performed using the PubMed database, and a total of 22 studies including 4,789 patients who underwent OLTx were relevant to this review. A prophylactic treatment was performed in 260 cases (6.2%) through splenic artery ligation in 98 patients (37.7%) and splenic artery banding in 102 (39.2%). In the patients who did not receive prophylaxis, SASS occurred after OLTx in 266 (5.5%) and was mainly treated by splenic artery embolization (78.9%). Splenic artery ligation and splenectomies were performed, respectively, in 6 and 20 patients (2.3% and 7.5%). The higher rate of complications registered was represented by biliary tract complications (9.7% in patients who received prophylaxis and 11.6% in patients who developed SASS), portal vein thrombosis (respectively, 7.3% and 6.9%), splenectomy (4.8% and 20.9%), and death from sepsis (4.8% and 30.2%). Whenever possible, prevention is the best way to approach SASS, considering all the potential damage arising from an arterial graft hypoperfusion. Where clinical conditions do not permit prophylaxis, an accurate risk assessment and postoperative monitoring are mandatory.

Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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