• Title/Summary/Keyword: Diabetic Patient

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Temporomandibular joint disorder from skull-base osteomyelitis: a case report

  • Lee, Suck-Chul;Kim, Jae-Hyung;Kim, Chul-Hoon;Kim, Bok-Joo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.39.1-39.6
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    • 2015
  • Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.

A CLINICAL CASE OF UNILATERAL MAXILLARY DEFECT RECONSTRUCTION USING NASOLABIAL FLAP (비순 피판을 이용한 상악골 편측 괴사환자의 치험례)

  • Lee, Eun-Young;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.167-172
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    • 2009
  • The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

Patient Experiences with Artificial Intelligence-Based Smartwatch for Diabetes Medication Monitoring Service (당뇨 환자용 인공지능 복약관리 스마트워치의 사용자 경험)

  • Lee, Mi Sun;Jeong, Suyong;Lee, Hwiwon
    • Journal of muscle and joint health
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    • v.29 no.1
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    • pp.50-59
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    • 2022
  • Purpose: This qualitative study aimed to explore the experiences of patients with diabetes provided with medication monitoring using an artificial intelligence-based smartwatch. Methods: Giorgi's descriptive phenomenological methodology was applied to collect and analyze data from November 9 to December 23, 2021. The study samples were recruited by convenience sampling, and even patients with diabetes participated in in-depth interviews via video conference and telephone calls or face-to-face visits. Results: Ten sub-themes and four themes were finally revealed. The four themes were as follows: journey with unfamiliar devices, a less-than-acceptable smartwatch, insufficient functions and content for patients with diabetes to use, and efforts for regular medication behaviors and daily monitoring of patient's health conditions. Conclusion: To effectively manage diabetic conditions using digital healthcare technologies, nursing interventions were needed to identify personal needs and consider technological, psychological, aesthetic, and socioeconomic aspects of wearable devices.

An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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Oxidative Modification of Human Ceruloplasmin by Methylglyoxal: An in vitro study

  • Kang, Jung-Hoon
    • BMB Reports
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    • v.39 no.3
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    • pp.335-338
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    • 2006
  • Methylglyoxal (MG) is an endogenous physiological metabolite which is present in increased concentrations in diabetics. MG reacts with the amino acids of proteins to form advanced glycation end products. In this in vitro study, we investigated the effect of MG on the structure and function of ceruloplasmin (CP) a serum oxidase carrier of copper ions in the human. When CP was incubated with MG, the protein showed increased electrophoretic mobility which represented the aggregates at a high concentration of MG (100 mM). MG-mediated CP aggregation led to the loss of enzymatic activity and the release of copper ions from the protein. Radical scavengers and copper ion chelators significantly prevented CP aggregation. CP is an important protein that circulates in plasma as a major copper transport protein. It is suggested that oxidative damage of CP by MG may induce perturbations of the copper transport system and subsequently lead to harmful intracellular condition. The proposed mechanism, in part, may provide an explanation for the deterioration of organs in the diabetic patient.

Surgical Resection of the Pulmonary Mucormycosis in the Diabetic Patient -1 case report- (당뇨병환자에서 발생한 폐모균증의 외과적 절제)

  • 김석기;서연호;김민호
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.915-918
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    • 2000
  • 폐모균증은 드물지만 치명적인 기회감염성 진균증으로 혈액종양, 신부전, 또는 당뇨와 같이 면역기능이 저하된 환자에서 주로 발생한다. 환자는 3년전부터 당뇨병 및 갑상선기능 항진증을 앓아온 32세 남자로 1개월간의 기침, 발열 및 좌측 흉통을 주소로 내원하였다. 기관지 내시경하 경기관지 폐생검상 폐모균증 진단되어 좌폐하엽절제술을 시행하였다. 술후 21일째 흉부방사선 사진 소견상 다수의 국소적인 흉막삼출로 흉강경을 이용한 배약술을 시행하였다. 환자는 술후합병증이 없이 흉강경배액술후 23일째 퇴원하였다. 기왕의 문헌보고에 의하면, 한쪽폐에 국한된 모균증을 가진 수술가능한 환자에서는 조기에 과감한 수술적 처치가 생존율을 높이는 것으로 제안하고 있다.

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Long-term Placement of Epidural Catheter - A case report - (경막외 카테터 초장기간 유치예에 대한 증례 보고)

  • Chae, Jung-Hae;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.3 no.1
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    • pp.59-62
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    • 1990
  • Epidural block is used for surgical analgesia, postoperative pain management, obstetric relief and management of chronic pain. Long-term pain control for chronic pain is achieved by development of epidural catheter placement technic. But long term placement of epidural catheteter has several problems, epidural hematoma, epidural absess and neural damage. We had successfully managed long-term placement of epidural catheter in patient with diabetic neuropathy who was susceptable to infection. The duration of epidural catheter placement was 416 days and specific complication was not occurred.

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Protamine Induced Anaphylactic Reaction after Cardiopulmonary Bypass -A case report- (체외순환 후 에 의해 유발된 아나필락시스 반응 - 1예 보고-)

  • 백종현;한승세;이정철;정태은;이장훈;이동협
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.606-608
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    • 2004
  • Anaphylactic reaction to protamine sulfate, which is used widely to reverse the anticoagulative effect of heparin after cardiopulmonary bypass, is very rare. But the result of anaphylactic reaction can be very fatal and the mechanism of it is still not clear. We report. a. case of severe anaphylactic reaction to protamine sulfate following the replacement of the mitral valve and .Maze procedure using microwave in a non-diabetic 57-year-old female patient.

Acute Osteomyelitis of Calcaneus - A Case Report - (급성 종골 골수염 - 증례 보고 -)

  • Sung, Il-Hoon;Whang, Kuhn-Sung;Lee, Ahm
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.134-138
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    • 2002
  • The acute osteomyelitis of calcaneus has been rarely reported. A diabetic patient, 44 year-old male was appeared with painful swelling on the hindfoot after being injected with steroid on the lateral area of hindfoot at a private clinic. The diagnosis was an acute calcaneal osteomyelits which was based on MRI finding. We report a case of the acute osteomyelitis of calcaneus, which was successfully treated with the curettage, antibiotic- impregnated bone cement beads, and delayed autogenous iliac bone graft, using the lateral approach.

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Microcomputer-Based Automatic Insulin Delivery System(Open-Loop Artificial Pancreas) (마이크로컴퓨터를 이용한 자동 인슐린 주입 장치에 관한 연구)

  • Yun, Jang-Hyeon;Min, Byeong-Gu;Kim, Jong-Sang
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.17 no.6
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    • pp.44-50
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    • 1980
  • A microcomputer based automatic insulin del ivory system was designed to control the speed of the Infusion pump depending upon the required amount of insulin at one minute interval for 24 hours. The desired insulin pattern for a diabetic patient was computed by computer programs based on a mathematical model of the insulin transport where the transport parameters were obtained using a linear regression analysis of the measured changes of insulin concentration in normal subjects.

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