• Title/Summary/Keyword: Old patient

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Treatment of Gynecomatia in a Patient with Prader-Willi Syndrome (Prader-Willi Syndrome 환자에서 여성형 유방의 치험례)

  • Kang, Nak Heon;Song, Seung Han;Oh, Sang Ha
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.656-658
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    • 2007
  • Purpose: Prader-Willi Syndrome(PWS) is a congenital chromosomal disorder characterized by compulsive and early development of obesity. Obesity is identified as the main cause of morbidity in PWS individuals. Also, body change for rapid weight gain, such as gynecomastia, can cause considerable functional and psychological trauma, We corrected successfully gynecomastia in PWS patient, so we reported our experience of surgical method and literature reviews. Methods: A 16-year-old male patient presented with gynecomastia. He was diagnosed as with PWS at pediatric department. We performed reduction mammaplasty using inferior pedicle and Wise pattern. Excision amount was 1350g in right breast and 1415g in left breast. Also, we managed upper and lateral fullness of breast with liposuction. Results: There were no specific complications, such as hematoma, infection, nipple-areola complex necrosis, and so on. Also, aesthetic and functional outcome was acceptable Conclusion: We experienced successful correction of gynecomastia in PWS patient, and found advantages of conventional reduction mammaplasty using inferior pedicle and Wise pattern at this specific situation.

Massive Hemorrhage Facial Fracture Patient Treated by Embolization

  • Kim, Moo Hyun;Yoo, Jae Hong;Kim, Seung Soo;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.17 no.1
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    • pp.28-30
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    • 2016
  • Major maxillofacial bone injury itself can be life threatening from both cardiovascular point of view, as well as airway obstruction. Significant hemorrhage from facial fracture is an uncommon occurrence, and there is little in the literature to guide the management of these patients. We report a 73-year-old male driver who was transported to our hospital after a motor vehicle collision. The patient was hypotensive and tachycardic at presentation and required active fluid resuscitation and transfusion. The patient was intubated to protect the airway. All external attempts to control the bleeding, from packing to fracture reduction, were unsuccessful. Emergency angiogram revealed the bleeding to originate from terminal branches of the sphenopalatine artery, which were embolized. This was associated with cessation of bleeding and stabilization of vital signs. Despite the age and severity of injury, the patient recovered well and was discharged home at 3 months with full employment. In facial trauma patients with intractable bleeding, transcatheter arterial embolization should be considered early in the course of management to decrease mortality rate.

A Treatment Case of Delayed Aortic Injury: The Patient with Posterior Rib Fracture

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.406-408
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    • 2014
  • A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

A Case Report of Warming Acupunture Therapy at Buyang, Golyun and Its Cotreatment with Traditional Korean Medicine in a Traffic Accident Patient with Neck Pain (교통사고 후 발생한 경항통 환자에 대한 부양, 곤륜혈의 온침 병행치료 증례보고)

  • Choi, Kang Min;Kim, Hyo Bin;Kim, Young Il
    • Journal of Haehwa Medicine
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    • v.28 no.2
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    • pp.48-53
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    • 2019
  • Objectives : The aim of this study was to observe the clinical effect of warming acupunture therapy at Buyang(BL59), Golyun(BL60) in a traffic accident patient with neck pain. Methods : A 32-years-old, female patient with neck pain was treated by warming acupunture therapy at Buyang(BL59), Golyun(BL60) from April 28th to May 5th. The improvement of the patient's neck pain was evaluated by Visual Analog Scale(VAS), Pain Rating Score(PRS) and Neck Disability Index(NDI). Result : After treatment, flexion & extension VAS was decreased from 7.0 to 3.0 and lateral bending VAS was decreased from 7.5 to 4.0. PRS and NDI was improved 70 to 54, 41 to 35, respectively. Conclusions : The result suggests that warming acupunture therapy at Buyang(BL59), Golyun(BL60) may have therapeutic effect on neck pain patients.

A Case Report of a Patient with Lewy's Body Dementia and Insomnia Treated with Korean Medicine (불면을 호소하는 Lewy's body dementia 환자 치험 1례)

  • Park, Min-jeong;Lee, Mi-rim;Kim, Gyeong-muk;Cho, Ki-ho;Moon, Sang-kwan;Kwon, Seung-won;Jung, Woo-sang
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.146-151
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    • 2017
  • The patient was a 69-year-old Korean male with Lewy's body dementia and insomnia. He was treated with acupuncture and a herbal medicine, Ukan-san. To evaluate insomnia, the patient's total sleeping time was recorded. The patient's sleeping time increased after the administration of the Korean medicine treatments. Treatment with Korean medicine may be effective in treating insomnia in cases of Lewy's body dementia.

Acute Motor Weakness of Opposite Lower Extremity after Percutaneous Epidural Neuroplasty

  • Lim, Yong Seok;Jung, Ki Tea;Park, Cheon Hee;Wee, Sang Woo;Sin, Sung Sik;Kim, Joon
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.144-147
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    • 2015
  • Recently, percutaneous epidural neuroplasty has become widely used to treat radicular pain caused by spinal stenosis or a herniated intervertebral disc. A 19-year-old female patient suffering from left radicular pain caused by an L4-L5 intervertebral disc herniation underwent percutaneous epidural neuroplasty of the left L5 nerve root using a Racz catheter. After the procedure, the patient complained of acute motor weakness in the right lower leg, on the opposite site to where the neuroplasty was conducted. Emergency surgery was performed, and swelling of the right L5 nerve root was discovered. The patient recovered her motor and sensory functions immediately after the surgery. Theoretically, the injection of a large volume of fluid in a patient with severe spinal stenosis during epidural neuroplasty can increase the pressure on the opposite side of the epidural space, which may cause injury of the opposite nerve by barotrauma from a closed compartment. Practitioners should be aware of this potential complication.

Klebsiella pneumoniae necrotizing fasciitis on the upper lip in a patient with uncontrolled diabetes

  • Kim, Hyeong Seop;Chang, Yong Joon;Chung, Chul Hoon
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.127-131
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    • 2020
  • A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

A Study of Bite Force of the Male Patients with TMJ Dysfunction (악관절기능장애환자(남성)의 교합력에 관한 연구)

  • 강규욱;이승우
    • Journal of Oral Medicine and Pain
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    • v.10 no.1
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    • pp.63-71
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    • 1985
  • A kinematical study of bite force during voluntary isometric contraction was investigated in 20 Korean men with TMJ dysfunction and 30 Korean men as normal subject, ranging from 20 to 27 years old. The author observed maximum bite force, slope of bite force graph, curve index and duration of maximum bite force with the use of the foil strain gauge (MPM-3000) and RS Dymograph (Beckman). The obtained results were as follows : 1. Maximum bite forces were 29kg and 29kg for left and right side of normal subject (p>0.05) and 19kg and 29kg for affected and non-affected side of TMJ dysfunction patient. 2. The slopes of bite force graph were $68^{\circ}$ and $68^{\circ}$ for left and right side of normal subject (p>0.05) and $59^{\circ}$ and $71^{\circ}$ for affected and non-affected side of TMJ dysfunction patient. (p<0.01) 3. The curve indices were 0.93 and 0.90 for left and right side of normal subject and 1.10 and 0.90 for affected and non-affected side of TMJ dysfunction patient. (p>0.05) 4. The durations of maximum bite force were 424 msec and 413 msec for left and right side of normal subject and 337 msec and 334 msec for affected and non-affected side of TMJ dysfunction patient. (p>0.05)

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False-positive I-131 Scan by Contaminated Muffler in a Patient with Thyroid Carcinoma (갑상선암 환자에서 방사성 옥소로 오염된 목도리에 의한 위양성 소견)

  • Seo, Han-Kyung;Kim, Min-Woo;Jeong, Hwan-Jeong;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.1
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    • pp.51-52
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    • 2006
  • A 39-year-old female patient who had undergone a total thyroidectomy for a papillary thyroid carcinoma underwent a whole body scan with I-131. The I-131 scan was performed 72 hours after administering 185 MBq (5 mCi) of an I-131 solution. The anterior image of the head, neck, and upper chest showed multiple areas of increased uptake in the mediastinal area considering of functional metastasis. However, radioactivity was not evident in the image taken after removing her clothes and muffler. The image obtained after placing the muffler on the pallet showed that the radioactivity was still present. It is well known that artifacts on an I-131 scan can be produced by styling hair sputum, drooling during sleep, chewing gum, and paper or a cloth handkerchief that is contaminated with the radioactive iodine from either perspiration or saliva. This activity might be mistaken for a functional metastasis. Therefore, it is essential that an image be obtained after removing the patient's clothes. In this study, artifacts due to a contaminated muffler on the I-131 scan were found. These mimicked a functional metastasis of the mediastinal area in a patient with a papillary thyroid carcinoma.

Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.