• Title/Summary/Keyword: Chief-complaint

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The Surgical Management of Esophageal Stenosis due to Lye Solution (가성소다에 의한 식도협착에 대한 외과적 치료)

  • 정영환
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.219-224
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    • 1973
  • 82 cases of esophageal stenosis due to lye solution in our hospital, which is surgicallly treated with retrosternal esophagoplasty were reported. female was 2 times more then male and average age is 30 years old. Dyphagia and precordial pain were chief complaint. In this technique, jejunum, right and left colon were substituted for constricted esophagus. Postoperative complication rate 14.6%, mortality rate due to other complication were 21.9% but had not seen in this operative technique.

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Leiomyosarcoma of the Pulmonary Artery (폐동맥에 발생한 평활근육종)

  • 안병희
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.166-169
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    • 1994
  • Primary malignant tumors originating in the pulmonary artery are extremely rare. Recently, We experienced a case of primary leiomyosarcoma occurred on the main pulmonary artery and extended into the Rt and Lt pulmonary artery. The patient was 44 year-old woman and the chief complaint was severe exertional dyspnea. Emergency pulmonary arteriotomy to relieve the pulmonary artery obstruction was performed on cardiopulmonary bypass. The tumor was 6 x6 x4 cm in size and infiltrated into the main pulomary artery. The tumor in the pulmonary artery was removed without any difficulties. The patient was recovered without any specific problems. The tumor was confirmed to be leiomyosamoma histopathologically.

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A Survey of Patients Visiting Pain Clinic (통증 치료실 내원 환자의 분석)

  • Seo, Chang-Min;Mun, Cheol-Won;Baek, Un-Yi;Hong, Jung-Gil
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.224-231
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    • 2000
  • Background: Currently, the number of patients visiting pain clinics is increasing with the augmented concerns of the patients about management of pain. We conducted this study in order to comprehend the characteristics of the patients visiting pain clinics and to find a method to further raises the public's awareness about pain treatment. Methods: We surveyed 497 new patients who had visited pain clinic of Kyungpook national university hospital from August 1998 to July 1999. We analysed these patients about their age, sex, chief complaint, duration of pain complaints, resident district, educational level and route of visiting pain clinic by use of questionnaire. Results: In age distribution, the largest proportion (29.8%) were in their 60's. Low back pain was the most common chief complaint (33.0%), the highest (43.7%) percentage of patients had complained of pain for over 6 months. Two thirds of the patients lived in urban area. Patients who were educated to only elementary school level made up the largest group with 35.3%. Referrals from former patients who had visited our pain clinic and had received treatment. Conclusions: As increasing patients who have pain complaints are related to social advanced age, it is prudent to consider the characteristics of age related pain complaints. And we have to guide the pain patients to have more earlier treatments using mass media because there is still insufficient general information about pain clinic and pain managements.

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DIASTEMA CLOSURE TREATMENT DECISION FOR AN ADOLESCENT PATIENT WITH CEREBRAL PALSY (뇌성마비인 청소년의 치간이개 치료법 결정 : 증례보고)

  • Lee, Koeun;Lee, Jae-Ho;Kang, Chung-Min
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.11 no.1
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    • pp.1-4
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    • 2015
  • Diastema is thought to be a problem related to aesthetics, pronunciation, or malocclusion. Due to its extent and patient conditions, orthodontic treatment, prosthodontic treatment, and conservative direct resin restoration are the treatment options for diastema closure. Additional factors need to be considered when deciding on the most appropriate treatment of diastema, particularly for patients with cerebral palsy. A 13-year-old girl visited the Department of Pediatric Dentistry at Yonsei University Dental Hospital with a chief complaint of the large gap between her upper front teeth. After clinical and radiographic examinations, midline diastema of 4.5 mm, protrusive maxilla incisors, congenital missing teeth, retained primary teeth, etc. were identified. Prosthodontic treatment with intentional root canal treatment was not appropriate because of the patient's age. Dental spaces can be closed effectively via orthodontic appliances. However, additional prosthodontic and restorative intervention is unavoidable, which incurs significant costs and requires more time. Instead of orthodontic and prosthodontic treatment, direct resin restoration can address the chief complaint; these restorations are reversible, less harmful to other oral structure and teeth, relatively easy to apply, less expensive than other treatments, and require shorter office visits. Midline diastema can be treated in several ways. For diastema closure in patients with cerebral palsy, conservative resin restorations are a short, simple, and appropriate treatment compared with orthodontic or prosthodontic treatments.

A novel FBN1 gene mutation associated with early-onset pneumothorax in Marfan syndrome

  • Park, Min Ji;Lee, Dong Hun;Shin, Young Lim;Hong, Yong Hee
    • Journal of Genetic Medicine
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    • v.13 no.1
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    • pp.41-45
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    • 2016
  • Marfan syndrome (MFS) is an inherited connective tissue disorder with a mutation in the fibrillin-1 (FBN1) gene. Fibrillin is a major building block of microfibrils, which constitute the structural component of the connective tissues. A 10-year-old girl visited our hospital with the chief complaint of precocious puberty. According to her medical history, she had a pulmonary wedge resection for a pneumothorax at 9 years of age. There was no family history of MFS. Mid parental height was 161.5 cm. The patient's height was 162 cm (>97th percentile), and her weight was 40 kg (75th-90th percentile). At the time of initial presentation, her bone age was approximately 11 years. From the ophthalmologic examination, there were no abnormal findings except myopia. There was no wrist sign. At the age of 14 years, she revisited the hospital with the chief complaint of scoliosis. Her height and weight were 170 cm and 50 kg, respectively, and she had arachnodactyly and wrist sign. We performed an echocardiograph and a test for the FBN1 gene mutation with direct sequencing of 65 coding exons, suspecting MFS. There were no cardiac abnormalities including mitral valve prolapse. A cytosine residue deletion in exon 7 (c.660delC) was detected. This is a novel mutation causing a frameshift in protein synthesis and predicted to create a premature stop codon. We report the case of a patient with MFS with a novel FBN1 gene missense mutation and a history of pneumothorax at a young age without cardiac abnormalities during her teenage years.

dissecting aortic aneurysm (DeBakey Type III) -Report of two cases- (박리성 대동맥류(DeBakey Type III)의 외과적 치험 -2예보고-)

  • 문경훈
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.443-448
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    • 1986
  • Aortic dissection is a serious disease that mortality does not approach to zero despite of medical and surgical improvement. Recently two cases of aortic dissection were treated with good results by the two other methods. Case 1 [57-Y-0-Male]; Chief complaint was chest pain radiating to the back. Preoperatively he was controlled by Minipress, dichlotride, & sodium nitroprusside. Aortography showed DeBakey Type III aortic dissection extending from just below the Lt. subclavian artery to the proximal portion of the origin of the renal artery. Through the midline long incision Flow reversal & Thrombo-exclusion method was used, and bypass course was proximal anastomosis at the ascending aorta - through the Rt. thoracic cavity - midportion of the diaphragm - posterior to the liver, stomach, & pancreas - distal anastomosis at the abdominal aorta proximal to its bifurcation. Bypass graft was preclotted 20 mm Dacron Woven Graft, and the aortic arch between the Lt. subclavian artery & Lt. common carotid artery was divided and meticulously sutured. Control aortogram which was done at 4th postoperative month revealed obstruction of the false lumen by thrombosis, and complications were not noticed. Case 2 [53-Y-0-Male]; Chief complaint was chest pain radiating to the abdomen. DeBakey Type III aortic dissection which was similar to the case 1 was detected by the aortography, and involvement of the Lt. subclavian & common carotid arteries was suspicious. Through the Lt. posterolateral thoracotomy the Ringed Intraluminal Sutureless Graft, No. 22 mm, was inserted from just below the Lt. common carotid artery to the midportion of the descending thoracic aorta under total circulation arrest using a F-F bypass, and the Lt. subclavian artery was ligated. Postoperatively hospital course was uneventful with antihypertensive drugs, and any specific complications were not noticed.

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A Case of Neuroblastoma Presenting with Sudden Blindness (실명을 주소로 한 신경아세포종 1예)

  • Ma, In-Youl;Hah, Jeong-Ok;Kim, Chun-Dong;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.259-264
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    • 1985
  • Neuroblastoma is the most common extracranial solid tumor of childhood which presents various clinical symptoms depending on the primary and metastatic sites. However, it has been rarely reported that sudden onset of blindness was the chief complaint of neuroblastoma. A four years old boy was admitted to the Yeungnam University Hospital with the chief complaint of a sudden onset of blindness due to a distant metastasis of abdominal neuroblastoma to the sphenoid sinus. On admission, both side pupils were dilated without light reflex, fundoscopy showed pale optic disk, electroretinogram was subnormal and visual evoked potential showed no response. The liver was palpable in $3{\frac{1}{2}}$ finger breadth from the right costal margin and adult fist sized mass was palpable in the right flank. Skull X-ray showed destructed sphenoid bone and clinoid process and brain CT scan showed tumor mass in the sphenoid sinus and left orbit. Ultrasonogram and CT scan of the abdomen showed large tumor masses around the right kidney and para-aortic and retropancreatic lymph node. IVP showed displaced right calyceal system with preserved contour. Left supraclavicular lymph node which appeared after admission was biopsied and it showed poorly differentiated neuroblasts. He was treated according to the multiagent chemotherapy schedule for stage IV neuroblastoma patient of children's cancer study group. Abdominal tumor masses and sphenoid sinus mass were markedly reduced after 2 courses of the combination chemotherapy of cyclophosphamide, vincristine, DTIC, adriamycin and VM-26. Eventhough the blindness was not improved, the patient has been in good clinical condition.

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Utilization Status of Emergency Medical Service for Children (아동의 응급의료서비스 이용실태)

  • Jeon, Hye-Jin;Kim, So-Sun;Bae, Hyun-A;Yoo, Il-Young
    • Child Health Nursing Research
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    • v.14 no.1
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    • pp.5-13
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    • 2008
  • Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.

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Retrospective Analysis of Chief Complaints and Causes of Dogs and Cats during Emergency Visits: 3,180 Cases (응급실에 내원하는 개와 고양이의 주증과 원인에 대한 후향분석: 3,180례)

  • Lee, Hyekyung;Son, Won-Gyun;Seo, Jimin;Kim, Hyunwook;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.90-94
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    • 2014
  • This study was performed to investigate on the frequent chief complaints and the causes of dogs and cats visiting to an emergency department, and to suggest the minimum requirements for veterinary emergency clinics in South Korea. The medical records were reviewed for 2,368 dogs and 347 cats visiting the emergency department of Haemaru Referral Animal Hospital from March 2012 to August 2013. Among them, 255 dogs and 35 cats visited more than one time and each visit was considered as an individual case. Therefore, 2,784 cases of dogs and 396 cases of cats were reviewed. The medical records were analyzed according to the criteria such as signalment, chief complaints, diagnoses, hospital admission, and outcome. In dogs, vomiting, diarrhea, or both were the most common chief complaints, followed by dyspnea, trauma, seizure, and lethargy. The most common causes of emergency visits were gastrointestinal disorders, followed by neurologic, cardiovascular, respiratory, urologic, and hematologic disorders. In cats, dyspnea was the most common chief complaint, followed by vomiting, diarrhea, or both, trauma, dysuria, and lethargy. The most common causes of emergency visits were urologic disorders followed by gastrointestinal, respiratory, infectious, and cardiovascular disorders. According to the results, vomiting, diarrhea, dyspnea, and trauma were the most frequently encountered chief complaints, which accounted for approximately 48.6% of all cases in both dogs and cats. However common causes were differed between the dogs and the cats. In order to provide proper emergency service, it is required to prepare the clinicians and facilities to diagnose and stabilize these emergency patients.