• 제목/요약/키워드: Old patient

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노인 외상 환자에 대한 분석 및 외상성 혈기흉의 임상양상 (Clinical Analysis of Old-aged Chest Trauma Patient and Traumatic Hemopneumothorax)

  • 김정태
    • Journal of Trauma and Injury
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    • 제22권2호
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    • pp.161-166
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    • 2009
  • Purpose: This study was conducted to analyze chest-trauma patients and the old-aged patients with a traumatic hemopneumothorax. Methods: We reviewed the medical records of 101 chest-trauma patients admitted to the department of cardiovascular and thoracic surgery from June 1999 to November 2008. We evaluated the general characteristics of the chest-trauma patient, especially those of old-aged patients with a traumatic hemopneumothorax. Results: Rib fracture was observed in 99 of the cases, the location distribution was right: left =261: 255, with right being dominant. Rib fractures commonly involved the 4th and the 7th rib. The average number of rib fractures was 5.1, and the average number of rib fractures in the old-aged patients was significantly higher than that in the non-old-aged patients (p=0.04). There were 17 cases of a hemopnuemothorax in old-aged patients, 52 cases in non-old-aged patients. The blood loss through the chest tube for old-aged patients was significantly more than that for the non-old-aged patients, and the initial hemoglobin level was lower in the old-aged patients. Conclusion: Elderly trauma patients are more likely to die after trauma than other age groups. Even with relatively stable vital signs, invasive hemodynamic monitoring and intensive treatment are recommended.

객혈을 주소로 하는 폐결핵 환자의 치험 1례 (A Case Report of Korean Traditional Medical Therapy for Patient of Hemoptysis with Old Pulmonary Tuberculosis)

  • 장문원;최성환;강지선;문승희;김민지;김윤식;설인찬;조현경
    • 대한한의학방제학회지
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    • 제16권2호
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    • pp.255-261
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    • 2008
  • Hemoptysis is a common clinical symptom responsible for about 10% of the patients who has the pulmonary disease. In Korea, pulmonary tuberculosis is still the most common cause of the hemoptysis. This study is a chlinical report of Korean Traditional Medical Therapy for the patient of hemopysis with old pulmonary tuberculosis. The patient was suffering from hemoptysis, headache, sweating, feeling of uneasiness and fatigue. After administration of herbal medicines (Bokryungbosim-tang, Yukmijihwangwon-gagambang) and acupunture treatment for 34days, these symptoms of the patient were improved. Thus, we concluded that Oriental Medical Treatment can improve the symptoms of the patient who is suffering from hemoptysis.

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대동맥판 폐쇄부전증이 동반된 심실중격결손증 수술의 장기 성적- 적절한 수술시기 및 수술 방법- (Long-term Results of Surgical Treatment for Ventricular Septal defect Associated Aortic Insufficiency-Proper Timing and Method of Surgical Treatment)

  • 김진국;함시영;서경필
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.254-269
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    • 1988
  • 52 cases of ventricular septal defect [VSD] associated with aortic insufficiency [Al] were found among 1271 patients with simple VSD operated during 27-year period [1959, August-1987, June] at Seoul National University Hospital. Their preoperative data, intraoperative findings and postoperative short-term and long-term follow-up data were evaluated to find the proper timing and method of surgical treatment. The result of this survey shows as follows: 1. To obtain the proper surgical indication, cardiac catheterization and angiography, especially root aortography, was essential. 2. Of all 52 patients, the VSD were type I in 40 patients [77%], type II in 8 [15%] and combination of type I and II in 4 [3%]. Patch closure of VSD were performed in 46 patients and direct suture closure of small VSD in 6. Most common pathologic findings of Al were prolapse of right coronary cusp [40 cases, 77%]. Aortic valve reconstruction were performed in 19 patients, aortic valve replacement in 6 and VSD closure alone in 27. 3. There were 3 surgical deaths [mortality 5.8%], and the long-term follow-up shows that VSD closure alone might have been sufficient to arrest progression of Al in younger patients [less than 10-year old], particularly in those with mild insufficiency. Valve reconstructions, when necessary, were more effective when done at an early age [less than 15-year old]. In a conclusion, we could recommend followings: 1. If patient at any age having VSD with Al is diagnosed, prompt operation is recommended. As for the surgical method, VSD closure only may be fit for mild degree of Al when patient is less than 10-year old, but the management of valve itself may be needed for moderate to severe degree of Al, especially when patient is over 10 year old. The management of valve itself may be variable, but valve reconstruction should be considered as a first choice in less than 15-year old patient. If patient is diagnosed less than 5-year old without evidence of Al, close follow-up observation is recommended. But if Al evidences of clinical findings and/or echocardiography during follow-up examination are notified, corrective operation should be accomplished while the Al is mild. If cusp prolapse and/or even type I VSD of significant size is demonstrated on aortogram, without Al, it should be corrected as early as possible before the patient is about 5 years old.

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Paroxysmal kinesigenic dyskinesia in a patient with a PRRT2 mutation and centrotemporal spike discharges on electroencephalogram: case report of a 10-year-old girl

  • Seo, Sun Young;You, Su Jeong
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.157-160
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    • 2016
  • Coexistence of paroxysmal kinesigenic dyskinesia (PKD) with benign infantile convulsion (BIC) and centrotemporal spikes (CTS) is very rare. A 10-year-old girl presented with a 3-year history of frequent attacks of staggering while laughing and of suddenly collapsing while walking. Interictal electroencephalogram (EEG) revealed bilateral CTS, but no changes in EEG were observed during movement. The patient's medical history showed afebrile seizures 6 months after birth, while the family history showed that the patient's mother and relatives on the mother's side had similar dyskinesia. Genetic testing demonstrated that the patient had a heterozygous mutation, c.649_650insC, in the PRRT2 gene. To our knowledge, this constitutes only the second report of a patient with PKD, BIC, CTS, and a PRRT2 mutation.

Polytetrafluoroethylene 인조혈관을 이용한 동맥재건술: 3례 보 (Three cases report of arterial bypass graft using polytetrafluoroethylene vascular prosthesis)

  • 이철세
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.691-697
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    • 1984
  • After the real birth of vascular surgery occurred with the introduction of the first practical arterial prosthesis about 50 years ago, a variety of potential vascular graft had been tested and rejected. Polytetrafluoroethylene [Teflon, PTFE] was first used as a vascular prosthesis in 1957. Thereafter this pros-thesis was first used clinically in 1972 and has subsequently been widely applied as a small and medium sized vessel replacement because it is easy to use and readily available. There are numerous reports of good results about Polytetrafluoroethylene graft. We experienced the three cases of arterial bypass graft using polytetrafluoroethylene vascular pros-thesis. First, 21 years old female patient had suffered from Takayasus disease which affected the left subclavian artery and right subclavian-left axillary extra anatomical bypass graft as done. Second, 64 years old male patient had suffered from Leriche syndrome for 12 years and the left axillofemoral and femorofemoral extra anatomical bypass graft was done. Third, 34 years old male patient had suffered from recurrent Buergers disease which affected the left popliteal artery and the isolated popliteal artery segment bypass graft was done. Relatively satisfactory result was obtained in early post-operative period in all three cases.

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성인에서 발견된 선천선 식도 - 기관지루 수술 치험 -1예 보고- (Congenital Bronchoesophageal Fistula without Esophageal Atresia in Adult -A case report-)

  • 최명석
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.1009-1013
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    • 1990
  • Congenital bronchoesophageal fistula is a rare anomaly that can appear in adult life uncommonly. There was a largest review that include 100 cases in the literature. In our case, he was 48 years old male patient who admitted for chronic coughing and recurrent lobar pneumonia on the right lower lobe since 10 years old. We could confirmed the fistular preoperatively by barium swallow examination and performed division of the fistula. The patient’s postoperative course was unremarkable. According Braimbridge’s classification, it was belonged to the type II.

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급성 범자율신경장해성신경병증 (Acute Pandysautonomic Neuropathy) 2개증례 (Acute Pandysautonomic Neuropathy 2 Cases)

  • 전종은;이용석;남현우;박성호
    • Annals of Clinical Neurophysiology
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    • 제3권1호
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    • pp.43-46
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    • 2001
  • Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.

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IVF 시술 실패한 여성 불임환자 1례와 남성 불임환자 1례의 임상보고 (Case Report of Each Example of a Female and a Male Patient Who Were Infertile and Failed in In Vitro Fertilization(IVF) Treatment)

  • 조진형
    • 대한한방부인과학회지
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    • 제25권4호
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    • pp.94-104
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    • 2012
  • Purpose: The purpose of this paper is to report the effect of Korean medicine treatments on a female and a male patient who were infertile and failed to in vitro fertilization(IVF) treatment. Methods: The patients are a 30-year-old female who had been diagnosed with the ovulation dysfunction caused by the depression of ovarian function, and a 33-year-old male who had been diagnosed with sperm defect. The female patient alone underwent Korean medicine treatment after the eighth failure in IVF treatment and the male patient received Korean medicine treatment along with his wife after he failed in the first IVF treatment. The Korean medicine applied include herb-medicine administration, acupuncture, moxibustion, Jwa-Hun, and Du-Han-Jok-Yeol treatment. Results: Through Korean medicine treatment the female patient had succeeded in the IVF treatment and she also recovered completely from allergic rhinitis. The male patient whose wife also received Korean medicine treatment with him got his wife pregnant naturally. Conclusions: This result concludes that Korean medicine treatment is effective in infertile patients. Therefore, there needs to be more of subsequent research on infertile patients that is based on Korean medicine treatment.

HRV 검사를 통한 피부과 내원환자의 자율신경 균형 및 스트레스 단면 연구 (The Cross Sectional Study of Autonomic Nerve Balance And Stress In Patient Who Visted Dept. of Oriental Medical Dermatology)

  • 김규석;남혜정
    • 한방안이비인후피부과학회지
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    • 제21권2호
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    • pp.142-153
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    • 2008
  • Objective : Etiologically, stress is a important factor to immune system and skin disease. Human body is controled to keep his homeostasis from stress by autonomic nerve system. So we investigated autonomic nerve balance and stress level of patients with skin disease by heart rate variability(HRV) test. Research Methods and Procedures : Fifty two patient(from 15 years old to 35 years old) who visited Dept. of Oriental medical Dermatology, Kyunghee university at first and had an examination by HRV test, were selected as the subject of our study. We checked items of HRV test(such as SDNN, RMSSD, VLF, LF, HF, TP, norm-LF, norm-HF, LF/HF ratio, LnHF and LnHF), and analyzed time and frequency domain by sex, age, onset, color on end of patient's tongue, sweating and sleep condition. Results and Conclusion : Men showed significant higher SDNN, RMSSD, LF, norm-LF, norm-HF, LF/HF ratio, LnLF and LnHF than women(p <0.05). Patients who were attacked by skin disease within 6 months, showed significant higher TP and VLF than over 6 months(p <0.05). Patients with normal color on the end of their tongue showed significant higher TP and VLF than with flare color. We analyzed correlation to color on the end of tongue and RMSSD. Prevalence risk(RMSSD <20ms) in the case of normal color on the end of tongue was 5 times as high as in the case of flare color(p <0.1). And we analyzed correlation to age and LF/HF ratio. Prevalence risk(LF/HF ratio <1) of patients from 15 years old to 25 years old was 1.467 times as high as from 26 years old to 35 years old(p <0.1).

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성인과 소아에서 치과 파노라마방사선검사의 환자선량 (Patient dose in adult and pediatric dental panoramic radiography in Korea)

  • 김은경;한원정;김경아;이완;윤숙자;황의환;김규태;허민석;안창현;안서영;한진우;정연화
    • 대한치과의사협회지
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    • 제55권8호
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    • pp.516-526
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    • 2017
  • Objective: To suggest diagnostic reference levels (DRLs) for dental panoramic radiography in adults and children through the nationwide survey in Korea. Materials and Methods: Two hundred twelve dental institutions on a national basis were visited. The radiographic examination protocols were surveyed and their patient doses at the clinical exposure setting for adult and children (5- and 10-year old) were measured at 244 panoramic radiographic equipment. The measured DAP were analyzed and compared according to age group, the size of hospital, the type of radiographic system, the installation duration of equipment. Results: The mean exposure parameters were 70.1 kV, 9.2 mA, 14.4 second for adult and 66.6 kV, 7.9 mA, 13.8 second for 10-year old child and 65.5 kV, 7.3 mA, 13.7 second for 5-year old child. The mean and third quartile patient DAPs were $138.3mGy\;cm^2$ and $151.0mGy\;cm^2$ for adult, $99.5mGy\;cm^2$ and $104.8mGy\;cm^2$ for 10-year old child and $89.5mGy\;cm^2$ and $95.5mGy\;cm^2$ for 5-year old child. The mean patient dose at the university dental hospital was lower than that at the dental clinic (p<0.05). The mean patient dose of direct digital radiography type was higher than that of film-based type. However, the difference did not show statistically significance. Conclusion: DRLs for dental panoramic radiography in adult, 10- and 5-year old child were suggested to be $151mGy\;cm^2$, $105mGy\;cm^2$, and $96mGy\;cm^2$ in Korea based on this nationwide survey.

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