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Acute Respiratory Distress during Impression Taking in a TMJ Dislocation Patient with Pneumonia (폐렴을 동반한 턱관절 탈구환자에서 인상채득 중 유발된 급성 호흡장애)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.119-126
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    • 2014
  • Difficulty in breathing can be very disconcerting to a patient who is conscious yet unable to breath normally. The common causes of acute respiratory distress include hyperventilation, vasodepressor syncope, asthma, heart failure, and hypoglycemia. In most of these situations, the patient does not exhibit respiratory distress unless an underlying medical disorder becomes acutely exacerbated. Examples of this include acute myocardial infarction, anaphylaxis, cerebrovascular accident, hyperglycemia, and hypoglycemia. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Therefore, the most dental patient should be cared gently as the stress reduction protocol. This is a case report of acute respiratory distress with vasodepressor syncope during alginate impression taking of mandibular teeth in a long-standing temporomandibular joint dislocated 93-years-old pneumonic patient.

Use of ADMSTM during sedation for dental treatment of an intellectually disabled patient: a case report

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk;Yang, Martin;Chang, Juhea
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.217-222
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    • 2016
  • Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS$^{TM}$), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS$^{TM}$ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.

A Case Report of Climacteric Symptoms in Premature Ovarian Failure Patient Who Has One Side Ovariectomy and Pelvic Tuberculosis (골반결핵과 단측 난소절제의 병력이 있는 환자의 조기 폐경 후 갱년기 증상 치험 1례)

  • Lee, Yeon-Kyeong;Yoo, Yung-Ki;Lee, Dong-Nyung;Kim, Hyung-Jun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.3
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    • pp.269-278
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    • 2008
  • Purpose: The purpose of this study is to report the effect of Traditional Korean Medicine therapy on climacteric symptoms in premature ovarian failure patient. Methods: The patient in this case was 32 years old female. She had a history of the right side ovariectomy and antituberculous chemoteraphy caused by pelvic tuberculosis. And she was diagnosed with premature ovarian failure in October, 2007. She had a climacteric symptoms when she admitted to the OBGY department of Se-Myung University in Je-Cheon. She received Korean Medicine therapies such as herbal medicine, moxibustion, acupuncture. We evaluated patient's health status by Kupperman's index and VAS. Results: After the treatment, the climacteric symptoms in premature ovarian failure patient was improved. Conclusion: This case study shows that Korean Medicine therapies have significant effect on climacteric symptoms in premature ovarian failure.

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Accessory penis: A rare method of peno-urethral separation of sexual function and voiding following successful complex hypospadias reconstruction with a free ileum flap

  • Elia, Rossella;Pafitanis, Georgios;Ciudad, Pedro;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.381-385
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    • 2019
  • Hypospadias is a congenital malformation of the male genitalia. The reconstructive objectives are to obtain voiding with laminar flow and satisfactory sexual function. Several urethroplasty techniques have been described, but for perineal or revisional cases no single technique has shown robust success. In this study, we describe the expanded use of intestinal flaps for urethral reconstruction and report a peculiar request from a patient to undergo peno-urethral separation after successful hypospadias repair with a free ileum flap. A 51-year-old male patient with perineal hypospadias underwent several urethral reconstructive procedures with poor outcomes. A free ileum flap was attempted as a substitute for the urethra. Following successful reconstruction, separation of the neo-urethra (ileum) from the penile body was performed to address the patient's sexual expectations. A free ileum flap proved to be a reliable urethral substitute in perineal hypospadias reconstruction, with a successful outcome. The peno-urethral separation with the creation of an "accessory penis," however peculiar, optimized the results in terms of both sexual and urinary function. Anatomical restoration of the urethra and patient-reported expectations are the key to successful hypospadias reconstructive procedures. Sexual function outcomes and the patient's perception of success should not be underestimated, even when urinary function has been restored.

Treatment of Chronic Cough in an Upper Airway Cough Syndrome (UACS)-Suspected Patient with Local Acupuncture Points Stimulation and Application of Topical Herbal Mixed Heating Cream : A Case Report (상기도기침증후군으로 의심되는 만성기침 환자에 대한 인후부 근위취혈 침치료 및 한약 온열크림 도포 경과 : 증례보고)

  • Kim, Eunmi;Jo, Hee-geun
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.557-565
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    • 2019
  • Objectives: This study investigated the effect of local acupuncture point stimulation and the application of a topical herbal mixed heating cream in a chronic cough patient who had not responded to various medications for more than a few months. Methods: An 81 year-old female patient who was suspected to be suffered from Upper Airway Cough Syndrome (UACS) was examined. The patient was treated with local acupuncture point stimulation and the application of a topical herbal mixed heating cream. We used the Leicester Cough Questionnaire, Cough-Specific Quality-of-Life Questionnaire, and Verbal Numerical Rating Scale to assess the patient's respiratory symptoms. Results: Local acupuncture point stimulation and the application of a topical herbal mixed heating cream resulted in the improvement of cough symptoms. The quality of life due to the alleviation of symptoms also significantly improved. Adverse effects were not observed. Conclusions: This study suggests that local acupuncture point stimulation and the application of a topical herbal mixed heating cream may be an effective therapy for the treatment of chronic cough in patients with UACS.

Types and Characteristics of Patient Safety Accidents among Hospitalized Children (입원아동의 안전사고 유형과 특성)

  • Kim, Eun Joo;Kim, Geun Myun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.25 no.3
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    • pp.182-190
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    • 2018
  • Purpose: This study was conducted to identify and analyze the types, characteristics, and frequency of patient safety accidents among hospitalized children. Methods: The data were collected from patient safety reports for 0-19-year-old patients from the National Health Insurance Corporation (NHIC) from January 1, 2016 through December 31, 2017. Using Excel software, a pivot table was used to classify and analyze the safety incidents, severity frequency, and characteristics of hospitalized child patients. Results: A total of 254 accident cases were reported involving child patients. The types of reports included medication accidents, falls, test errors, and others. Medication accidents accounted for 47.2% of the total reported cases. Regarding the severity of reported risk, there were no complications nor sequelae in 80.4% of the cases. Conclusion: This study is significant for systematically analyzing and reporting data reported about safety accidents among hospitalized children. These results will contribute further to preventing safety accidents in hospitalized children and to creating a desirable patient safety culture.

A Case of Restless Legs Syndrome Patient with Numbness in Both Soles Using Gyejibokryeong-hwan (하지불안증후군으로 인한 양 발바닥 저림에 대한 한의 치험 1례)

  • Yang, Jung-yun;Kim, Se-won;Lee, Yu-jin;Cho, Ki-ho;Moon, Sang-kwan;Jung, Woo-sang;Kwon, Seung-won
    • The Journal of Internal Korean Medicine
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    • v.40 no.2
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    • pp.270-278
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    • 2019
  • Objective: In this case report, we address the case of a 68-year-old woman with numbness in both soles due to restless legs syndrome. Methods: A patient was treated with Korean medicine including herbal medication Gyejibokryeong-hwan during 73 days as an outpatient. We evaluated the improvements of symptoms by use of the International Restless Legs Scale (IRLS) and checking subjective symptoms of patient. Results: After 73 days of Korean medicine treatment, there was improvement in patient's symptoms. IRLS score improved from 12 to 8, and subjective symptoms improved to about 30% compared to the first time. Conclusions: This study suggested that Korean medicine treatments might be effective in RLS patient recovery.

A Case Report of Efficacy of Saenggan-tang on a Patient with Drug Induced Liver Injury (약인성 간손상 환자에 대한 생간탕(生肝湯) 치험 1례)

  • An, So-yeon;Joo, Seong-hee;Hur, So-yeong;Jang, Eun-gyeong;Lee, Jang-hoon;Kim, Young-chul
    • The Journal of Internal Korean Medicine
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    • v.40 no.2
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    • pp.201-207
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    • 2019
  • Objectives: The purpose of this case study is to report the effect of Korean Medicine treatment on a patient diagnosed with drug-induced liver injury by oral administration of acetaminophen. Methods: A 21-year-old male patient with drug-induced liver injury visited the clinic five times from January 28th, 2019 to March 16th, 2019. The patient took Saenggan-tang extract during the treatment period. Results: The levels of serum alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) were significantly decreased. The chief complaints of the patient, such as yellow-red urine and fatigue, were also relieved. Conclusion: Traditional Korean medicine has a beneficial effect on drug-induced liver injury.

A Case Report of Verruca Vulgaris Patient, Treated only with Korean Medicine (한약 단독 치료를 이용한 심상성 사마귀 1례 보고)

  • Kim, Ji-Hong;Seo, Hyung-Sik;Lee, Ma-Eum;Jeong, Mi-Rae;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.154-163
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    • 2021
  • Objectives : The purpose of this study is to report a case of verruca vulgaris patient, treated only with Korean medicine. Methods : A 6-years-old female patient was treated only with Korean medicine due to verruca vulgaris on left hand. Photographs and size measurements of lesions were used to evaluate the changes in symptoms. Results : After 3 months of treatment, the patient's lesions showed almost complete clearance and there were no adverse effects. Conclusions : According to the results, Korean medicine with Bojungikgi-tang Hab Saengmaek-san Gamibang could be an effective and safe treatment for verruca vulgaris in a pediatric patient.

Traumatic urethra injury presenting as urethral cancer : A case study (외상성 요도 손상으로 오인된 요도암)

  • Shin, Sang-Yol;Hwang, Yong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.147-154
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    • 2020
  • Purpose: The purpose of the study was to investigate traumatic urethral injury in a 63-year-old patient with hematuria. Methods: A hematuria patient was transferred by paramedics. At the time of the visit, the patient's blood pressure (151/91mmHg), pulse rate (86/min), body temperature (37.1℃), and other vital signs were stable. Their KTAS (Korean Triage and Acuity Scale) was Level 4. The patient had no damage to the injured area, but a large contrast defect was observed between the prostate urethra and the bladder in urethral angiography performed due to persistent hematuria and pain in the injured area. Results: Following radiological evaluation of a suspected liposarcoma or neuroma mass of the prostate urethra, the mass was removed through urethral tumor resection. The result of histologic evaluation provided a diagnosis of highly differentiated invasive urethral cell carcinoma that had invaded the muscle layer. The patient was given additional treatment for urethral cancer but was rejected and is currently being followed. Conclusion: The prognosis for urinary tract cancer has distinct differences for patients with lymph node metastasis and tumor characteristics. The presence or absence of urethral cancer should be confirmed through angiography, CT, MRI, and cystoscopy.