• Title/Summary/Keyword: Fever management

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Management of post-pneumonectomy empyema (전폐절제술후 발생한 농흉의 치료)

  • 이석재
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.845-850
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    • 1993
  • Post-Pneumonectomy Empyema[PPE] is a relatively uncommon but serious complication. And the management of it remains a disturbing and controversial area in the field of general thoracic surgery. Many methods have described and have had varying degrees of success. For the purpose of providing the guideline for management of post-pneumonectomy empyema, we reviewed our experiences of treatment of PPE from January 1985. to December 1992. There were 17 cases, which consist 7.9% of all pneumonectomy cases for that period. There were 13 male and 4 female patients with mean age of 47.1$\pm$ 16.2 yrs old. Both chest has the same incidence. The most common disease for prior pneumonectomy was tuberculosis, but the PPE was the most frequently occurred in empyema. The duration between pneumonectomy and PPE was 44.7 $\pm$81.1 months, where 58.8% of patients occurred within 1 month. Fever was the most frequent complaint and wound dischrge was detected in less than half of patients. There were 2 in-hospital mortalities.Mostly, in 13 cases, we did Eloesser operation. Five of them could finish second Clagett procedure, but one had recurrence. Four bronchopleural fistular patients underwent 3 single stage muscle flap closure and 1 direct closure with modified Clagett procedure. None had recurrence. Mean follow-up duration is 30.9\ulcorner22.3 months. There was 1 late death which was not related to PPE but to Malignancy recurrence.

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Plan for the Development of a Standardized Dummy for Persons in Need of Rescue in a Confined Space (밀폐공간 구조 요구자를 위한 더미 표준화 개발 방안)

  • Choi, Seo-Yeon;Rie, Dong-Ho;Kim, Hyung-Jun
    • Journal of the Korea Safety Management & Science
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    • v.18 no.4
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    • pp.99-105
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    • 2016
  • This study was conducted to develop a dummy in an environment similar to the human body, to prepare a standard for evaluation and to present the process of the production in order to evaluate the performance of the robot that can detect the persons needing rescue in a confined space, who are difficult for fire-fighting officials to rescue in case of fire and disaster. As a result, a standard for evaluation was developed and standardized into four parts 'Normal,' 'Risk Stage 1,' 'Risk Stage 2' and 'Risk Stage 3'based on the number of breath cycles, carbon dioxide concentration, core temperature and criteria for hearing to recognize the voice. In addition, in order to produce a dummy, fever, breathing capacity and voice output function were compared and analyzed. This study has significance that it built up basic data of the method of producing the actual dummy, by presenting characteristics and controlling methods using the waterproof insulation heating coil for the function, solenoid valve for the consecutive output of breathing capacity and USB program sound board for voice output.

Challenging management of chorioamnionitis with placental listeriosis: lessons from 2 cases

  • Park, Ji Hyun;Ahn, Jung Hwan;Seo, Kyung Jin;Choi, Sae Kyung;Park, In Yang;Kim, Yeon-Hee
    • Obstetrics & gynecology science
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    • v.61 no.6
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    • pp.688-692
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    • 2018
  • Listeriosis is a rare foodborne infection caused by Listeria monocytogenes. It is 12-20 times more prevalent in pregnant women compared to the general population, with a 20-40% mortality rate in neonates. Early treatment with appropriate antimicrobial agents is critical for pregnancy outcomes; however, the infection is difficult to control because the nonspecific clinical manifestations and rarity of the disease often preclude early diagnosis. We encountered 2 cases of pregnancy-associated listeriosis that occurred at 29 and 37 weeks of gestation. Both neonates were delivered by emergent cesarean section due to fetal condition, and one of the preterm infants died immediately after birth. Pregnancy-associated listeriosis should be considered in the management of unexplained fever or inflammatory conditions in pregnant women.

The Educational Needs of a Mother when Nurturing Children (아동 양육에 관한 어머니의 교육 요구도)

  • Yoo, Kyung-Hee
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.905-916
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    • 2000
  • The purpose of this study was to investigate the educational needs of a mother when nurturing children from neonates to the schoolage. A total of 657 subjects responded to the survey about the level of educational needs when nurturing children. The subjects of the study constituted of 401 mothers who visited the health center for immunization and 256 mothers who visited the pediatric outpatient department or whose children were hospitalized in pediatrics. This instrument had 64 items about nurturing children from neonates to the schoolage and one item had a score range of one to four. In data analysis, SPSSWIN 9.0 program was utilized for descriptive statistics. The results were as follows. 1) Mothers who had the neonates represented the highest educational needs about parental-neonates attachments with 3.47 of mean score compared to neonatal convulsion(3.44), management of common colds(3.44), nutrition (3.44), fever control (3.42). 2) Mothers who had infancy represented the highest educational needs about management of common colds with 3.34 of mean score compared to psychosocial developments (3.23), management of foreign bodies (3.22), feeding the food(3.19), playing with the infant(3.16). 3) Mothers who had toddlers represented the highest educational needs about psychosocial developments with 3.35 of mean score compared to discipline for children(3.34), management of teeth (3.29), management of common colds (3.21), management of accidents(3.20). 4) Mothers who had the a child in preschool represented the highest educational needs about psychosocial developments with 3.53 of mean score compared to management of accidents(3.23), discipline for children (3.00). 5) Mothers who had the child in secondary school represented the highest educational needs about psychosocial developments with 3.42 of mean score compared to management of teeth(3.13), management of accidents (3.05).

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Two Cases of Perforated Typhlitis in Acute Lymphocytic Leukemia (급성 림프구성 백혈병에 합병된 천공성 typhlitis)

  • Park, Woo-Hyun;Ahn, Keun-Soo;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.59-63
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    • 2001
  • The authors, over the last 6 months, have treated 2 patients with perforated typhlitis complicating acute lymphocytic leukemia (ALL) with good outcome. The first patient was a 13-year-old male who developed intermittent high fever, abdominal pain, abdominal distention and diarrhea during the course of maintenance chemotherapy. The peripheral leukocyte ranged from 230-470/$mm^3$. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal and ascending colonic walls and subsequent ragged perforation of the posterior wall of the cecum. He survived after treatment by right hemicolectomy and aggressive supportive measures. The patient case was a 3 year-old female who developed intermittent high fever, right lower abdominal pain, a mass, and watery diarrhea during the course of maintenance chemotherapy. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal wall (6-15mm in thickness) and subsequent small perforation of the posterior wall of the cecum with thick-walled localized abscess. She has recovered completely after aggressive medical management. We learned two lessons from our experience treating these patients:1) early diagnosis provided by a high index of suspicion and the use of ultra sonogram or CT scan is essential. And 2) although perforation is one of the surgical indications for the treatment of typhlitis, it is possible to manage the perforation nonoperatively in selected cases with localized abscess.

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The Clinical Study on a Case of Acute Myelogenous Leukemia (급성 골수성 백혈병 10세 환아의 한방적 처치에 대한 증례보고)

  • Ha, Kwang-Su;Song, In-Sun;Shin, Ji-Na;Lee, Jeong-Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.49-59
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    • 2004
  • Objective : The purpose of this study is to demonstrate the therapeutic effect of oriental treatment on Acute Myelogenous Leukemia. Methods : The patient was treated by Acupuncture, Indirect Moxibustion, Herb Medicine (Seogakjihwangtang-gamibang), and had significant improvement in the Acute Myelogenous Leukemia. Results : 1. Acute Leukemia is one of the most common malignant neoplasm of pediatrics, and is chracterised by anemia, infections, bleeding, debility, paleness, fever, anorexia, lymphoadenia, hepatomegaly, splenomegaly, etc. 2. The management of Acute Myelogenous Leukemia consists of the challenge of optimizing chance for prolonged remission and cure, while minimizing the toxicity to the patients. Therefore oriental medical treatment may be useful for this. 3. We experienced a case of the 10-year-old male patient with Acute Myelogenous Leukemia, after oriental medical treatment his chief symptoms(anemia, bleeding, purpura, debility, paleness, fever, anorexia, insomnia, etc)and general condition were improved. Conclusion : A 10-year-old male patient with Acute Myelogenous Leukemia, after oriental medical treatment his chief symptoms and general condition were improved. This oriental medical treatment may be possible or effective in Acute Myelogenous Leukemia. The more clinical study about oriental medical treatment on Acute Myelogenous Leukemia will be needed.

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Successful Treatment with Partial Splenic Embolization in a Case of Post-transplantations Lymphoproliferative Disease with Persistent Hypersplenism (림프세포증식성 질환에서 효과를 보인 부분적 비동맥 색전술 1례)

  • Kim, Mi Jin;Rho, Young Il;Yang, Eun Seok;Moon, Kyung Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.92-97
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    • 2004
  • Posttranplantations lymphoproliferative disease (PTLD) is a common and life-threatening complication for soid organ transplantation associated with the use of chronic immunosuppression and Epstein-Barr virus. There is no standardized treatment algorithm, but numerous management strategies are vaiable. Partial splenic embolization (PSE) had been demonstrated to be an effetive alternatie to splenectomy for patients hypersplenism and portal hypertension. PSE has the advantages of non-invasive intervention and resolution of the complications of hypersplenism. We report the effect of the PSE in a 6-year old male liver transplantation recepient with PTLD who has undergone persistent hypersplenism post-transplant. We reduced immunosuppression agent, started antiviral agent. We started with interferon and IV globulin one month after admission. Hepatosplenomegaly and cervical lymphadenopathy were improved. But fever was not subside. We selectively embolized the lower pole of the spleen to achieve a 50~60% reduction in flow as determined by angiography. After embolization, fever subside and peripheral blood findings were improved. Follow up abdominal CT revealed reduced volume of spleen due to ischemic change and there was no multiple enlarged mesenteric lymphnode compared to preembolization state. We thick that PSE is a safe an effetive treatment modality of PTLD with persistent hypersplenism in patients twho failed to medical treatment.

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A Case Study of a Somatoform Disorder Patient Diagnosed with Soyangin Symptomatic Pattern of 'Yin-Deficiency-Midday-Fever (陰虛午熱證)' (신체형장애(身體形障碍)를 호소하는 소음인(少陰人) 음허오열증(陰虛午熱證) 치험(治險) 일례(一例))

  • Jang, Hyun-Su;Kim, Yun-Hee;Kim, Sang-Hyuk;Lee, Jun-Hee;Lee, Eui-Ju;Song, Il-Byung;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.2
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    • pp.119-128
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    • 2008
  • 1. Objectives This case study describes a successful treatment process of a Soyangin patient with somatoform autonomic dysfunction symptoms using Soyangin therapeutic measures, including administration of Dokhwaljihwang-tang (獨活地黃湯) and Sibyimijihwang-tang (十二味地黃湯). 2. Methods The patient was treated with several constitutionally discriminated medicinal agents (獨活地黃湯, 十二味地黃湯) and acupunctural therapy accompanied by simultaneous western medical management. The visual analogue scale (VAS) was applied to assess the severity of flushing. 3. Results and Conclusions As flushing was one of the chief complaints, the patient was treated with Soyangin therapeutic measures including Dokhwaljihwang-tang and Sibyimijihwang-tang. The patient responded positively to the therapy, but further studies are anticipated for more definitive conclusions.

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A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy

  • Ra, Moni;Kim, Myungkyu;Kim, Mincheol;Shim, Sangwoo;Hong, Seong Yeon
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.84-88
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    • 2018
  • A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature $38.7^{\circ}C$, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

One case of SLE patient and the other case of perniotic LE patient (전신성 홍반성 루프스 환자 1례와 동창상 홍반성 루프스 환자 1례에 관한 임상적 고찰)

  • Ryeu, Hyeun-Sin;Lee, Jun-Seong;Kim, Jeong-Ho;Lee, Yong-Koo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.244-251
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    • 2002
  • Introduction: SLE is autoimmune disease to appear systemic pathology in the connective tissue. Perniotic LE is sub-type of chronic dermal LE which causes purple macules on the terminal part of body-nose, ends of fingers, heals, calfs of the legs, elbows and knees. Objective: The purpose of this study was to estimate the efficiency of oriental medical treatment and management on the SLE and perniotic LE. Subject: We studied 2 patients who visited and hospitalized in Daejon University Oriental Hospital Dept. of Dermatology, with SLE and pemiotic LE from April 2002 till May 2002 Method: We treated them with herb medication, acupuncture and in addition to we consulted western medication if they were needed Results: In case of SLE patient, we considered it to be Yeol-Dok-Chi-Seong, so we priscriped Ga-Mi-So-Dok-Eum1, 2 , Yang-Dok-Baek-ho-Tang first. and till 22 days of hospitalization, we considered to be Gi-Eum-Yang-Heo and priscriped Ji-Hwang-Tang-Hab-Cheong-Sim-Yeon- Ja -Eum-Ga-Mi. but it wasn't adjust and high fever was reaccurred. And till 24 days of hospitalization we priscriped Gal-Geon-Hae-Gi-Tang, and becomed to 25 days, high fever was disappeared and the patient discharged and she has remained generally good condition. In case of Perniotic LE, at first we misdiagnosed her disease as a acral lentiginous melanoma, and we considered it to be Gan-Soo-Yeol-Li-Yeol- Jeung and priscriped Cheong-Pae-Sa-Gan-Tang and transferred her to another hospital, but she was diagnosed Perniotic LE Conclusion: Considering the above results, in case of SLE, in acute phase, we could treat her with oriental-western treatment, and in relief phase, we could treat her with only oriental treatment very efficiently. but in case of perniotic LE, we misdiagnosed it as a acral lentiginous melanoma, but we could experienced very rare perniotic LE case. And also further study is needed on the SLE, and perniotic LE, and we have to systematize of dyagnosis and treatment system.

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