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A Case of a 16-Year-Old Patient With Chronic Invasive Aspergillosis in the Trachea Treated With Segmental Tracheal Resection and Cricotracheal Anastomosis

  • Heo, Yujin;Choi, Nayeon;Yoo, Keon Hee;Chung, Man Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.42-44
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    • 2022
  • Chronic invasive aspergillosis is a life-threatening disease, especially in immunocompromised patients. The diagnosis and treatment of tracheal aspergillosis (TA) are challenging because of its rarity and nonspecific clinical presentations. The treatment standard of TA has been medical treatment like other forms of invasive aspergillosis, but patients with medically resistant TA require surgical intervention. We demonstrated a successful surgical outcome of chronic invasive TA in a 16-year-old patient with immunocompromised status related to acute myelocytic leukemia.

Renal artery stenosis presenting as congenital nephrotic syndrome with hyponatremic hypertensive syndrome in a 2-month-old infant: a case report

  • Dabin Kim;Yo Han Ahn;Hee Gyung Kang;Ji Hyun Kim;Seon Hee Lim
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.117-120
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    • 2023
  • Here, we present the case of a 2-month-old male infant with hyponatremic hypertensive syndrome resulting from stenosis of the right proximal and mid-renal arteries. The patient exhibited nephrotic-range proteinuria, low serum albumin, increased serum creatinine, and elevated renin and aldosterone levels. Doppler ultrasonography and computed tomography angiography revealed decreased vascular flow in the small right renal artery. Following a successful percutaneous balloon angioplasty, the patient experienced a decrease in blood pressure and normalization of serum electrolyte levels within a few days. However, it took 3 months for the proteinuria to resolve completely. This case is significant as it represents the first reported instance of a neonate presenting with clinical features resembling congenital nephrotic syndrome caused by renal artery stenosis that was successfully treated with percutaneous renal angioplasty.

Case Report of a Patient Who Experienced Symptomatic Improvement Using Combined TMJ Balancing Therapy to Chronic Patellofemoral Pain (만성 슬개대퇴통증 환자에 턱관절균형요법을 병용하여 증상 개선을 보인 치험 1례)

  • Gawon Choe
    • Journal of TMJ Balancing Medicine
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    • v.13 no.1
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    • pp.27-31
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    • 2023
  • The purpose of this case report is to introduce a case of immediate results with TMJ balancing therapy (TBT) in the treatment of chronic patellofemoral pain (PFP). A 17-year-old female patient with 4-month-old chronic knee pain that was unresponsive to conventional treatment was treated with TBT for a total of 5 sessions. The primary outcomes were evaluated using the Numeric Rating Scale (NRS) and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC). Following the first treatment, the NRS decreased rapidly, and the KWOMAC improved after a total of five treatments. These findings suggest that TBT can be an effective pain management option for chronic PFP patients with temporomandibular joint malposition. However, as this study is a report of a single case, further research is necessary.

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Right Bochdalek hernia with pneumothorax in adult (성인에서 기흉을 동반한 우측의 Bochdalek Hernia 1)

  • 백광제
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.729-734
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    • 1984
  • Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

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A CASE OF NARCOLEPSY IN A 11 YEAR-OLD BOY (소아 기면증 1예)

  • Choi, Bo-Moon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.4 no.1
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    • pp.173-178
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    • 1993
  • Narcolepsy's age at onset is reported to be relatively homogeneous, occuring usually after the onset of puberty, although most cases are diagnosed when the patients are in their late teens to late 20s. It is very unusual for a patient to develop narcolepsy before 15 years of age or after 30 years of age. A 11-year old boy who has developed excessive daytime sleepiness since age of 7 and has all the four major features of narcolepsy by the time of evaluation is presented. On polysomnographic examination, the patient showed two sleep onset REM periods in the three latency test of the multiple sleep latency test and the nocturnal polysomnogram. In addition, the findings of typing HLA class I and II of the patient's family are presented. Reports of pediatric narcolepsy previously reported are reviewed.

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Morgagni Hernia in a 3-year Old Boy - a Case Report - (3세 남아에서 발생한 Morgagni 탈장 - 1예 보고 -)

  • Jeong, Hye-Yeon;Kim, Ae-Suk;Choi, Sung-Min;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.81-86
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    • 2007
  • A 3-year-old boy with purulent otitis media received a chest radiograph as the part of a routine work up. The patient was normal appearing, in no acute distress. The patient's lung and heart sounds were clear and normal. The patient's abdomen was soft, non-distended, and non-tender. An anterior cardiophrenic mass was incidentally identified on the lateral chest radiograph. A computed tomography scan demonstrated a diaphragmatic hernia with bowel loops in the retrosternal space. An exploratory operation revealed a diaphragmatic defect (4 cm in diameter) on the left side of the falciform ligament, through which transverse colon was protruded. There was no hernia sac, and the defect was closed with interrupted No. 2 silk sutures. The child was discharged on the 8th postoperative day without any complications. During 6 months of follow-up period, recurrence was not noticed.

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Failure of Fecal Microbiota Transplantation in a Three-Year-Old Child with Severe Refractory Ulcerative Colitis

  • Kumagai, Hideki;Yokoyama, Koji;Imagawa, Tomoyuki;Inoue, Shun;Tulyeu, Janyerkye;Tanaka, Mamoru;Yamagata, Takanori
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.214-220
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    • 2016
  • Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (${\times}2$) and via a nasoduodenal tube (${\times}4$) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.

A Case of Idiopathic Portal Hypertension in a 3-year-old Girl (3세 여아에서 진단된 특발성 문맥 고혈압 1예)

  • Son, Ki-Young;Baek, Seoung-Yon;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.221-225
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    • 2007
  • A previously healthy 3-year-old girl was admitted to the Department of Pediatrics in Severance Hospital with sudden symptoms of melena. The vital signs were stable, and splenomegaly was found in a physical examination. The patient had moderate thrombocytopenia. There was no evidence of autoimmune disease. A upper gastrointestinal endoscopy and esophagogram showed a varix on the lower esophagus. Coarse liver parenchymal echoes and increased periportal echogenicity were seen on a Doppler sonogram. The velocity of the portal vein mildly increased. Magnetic-resonance-cholangiopancreatogram (MRCP) demonstrated normal portal structures. A sono-guided liver biopsy was performed, but the pathological findings were unremarkable. Based on these findings, we diagnosed the patient with idiopathic portal hypertension. The patient was discharged and was treated with oral beta blocker. We report a case of idiopathic portal hypertension with a brief review of the literature.

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Depressing and Blood Glucose Testing in Women Type2 Diabetic Patients (여성 당뇨병환자의 우울과 자가 혈당측정 회수)

  • Kim, Hee-Seung;Park, Chai-Soon
    • Women's Health Nursing
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    • v.9 no.4
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    • pp.432-438
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    • 2003
  • Purpose: The purpose of this study was to investigate the depression and, the frequency of blood glucose testing in women type2 diabetic patients. Method: 114 Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. Depression was measured by visual analogue scale. Blood glucose testing was measured the frequency during past 1 week. Result: Depression was higher in hyperglycemia patient (fasting blood glucose$\geq$110mg/dl) than in normoglycemia patient(fasting blood glucose <110mg/dl). The blood glucose testing frequency as lower in 50-59 years old than in less than 39 years old. And it was lower in middle school graduate than in college graduate. The blood glucose testing was negatively correlated with patient's age. Conclusion: The depression program should be developed for hyperglycemia diabetic patients. And the blood glucose testing education program should be developed for aged and low educational level patients.

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Eosinophilic gastroenteritis in an 18-year-old male with prolonged nephrotic syndrome

  • Choi, Da Min;Pyun, Jung Eun;Yim, Hyung Eun;Yoo, Kee Hwan;Shim, Jung Ok;Lee, Eun Jung;Won, Nam Hee
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.72-75
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    • 2016
  • Eosinophilic gastroenteritis is a rare disease characterized by prominent eosinophilic tissue infiltration of the gastrointestinal tract. Here, we report a case of eosinophilic gastroenteritis in an 18-year-old patient with prolonged nephrotic syndrome who presented with abdominal pain and peripheral hypereosinophilia. During the previous 2 years, he had visited local Emergency Department several times because of epigastric pain and nausea. He had been treated with steroid-dependent nephrotic syndrome since 3 years of age. Tests ruled out allergic and parasitic disease etiologies. Gastroduodenoscopy with biopsy revealed marked eosinophilic infiltration in the duodenum. Renal biopsy findings indicated minimal change disease spectrum without eosinophilic infiltration. The oral deflazacort dosage was increased, and the patient was discharged after abdominal pain resolved. To our knowledge, this is the first report of eosinophilic gastroenteritis in a patient with minimal change disease.