• 제목/요약/키워드: Old patient

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Unpredictable Postoperative Global Cerebral Infarction in the Patient of Williams Syndrome Accompanying Moyamoya Disease

  • Sim, Yang-Won;Lee, Mou-Seop;Kim, Young-Gyu;Kim, Dong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제50권3호
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    • pp.256-259
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    • 2011
  • We report a rare case of Williams syndrome accompanying moyamoya disease in whom postoperative global cerebral infarction occurred unpredictably. Williams syndrome is an uncommon hereditary disorder associated with the connective tissue abnormalities and cardiovascular disease. To our knowledge, our case report is the second case of Williams syndrome accompanying moyamoya disease. A 9-year-old boy was presented with right hemiparesis after second operation for coarctation of aorta. He was diagnosed as having Williams syndrome at the age of 1 year. Brain MRI showed left cerebral cortical infarction, and angiography showed severe stenosis of bilateral internal carotid arteries and moyamoya vessels. To reduce the risk of furthermore cerebral infarction, we performed indirect anastomosis successfully. Postoperatively, the patient recovered well, but at postoperative third day, without any unusual predictive abnormal findings the patient's pupils were suddenly dilated. Brain CT showed the global cerebral infarction. Despite of vigorous treatment, the patient was not recovered and fell in brain death one week later. We suggest that in this kind of labile patient with Williams syndrome accompanying moyamoya disease, postoperative sedation should be done with more thorough strict patient monitoring than usual moyamoya patients. Also, we should decide the revascularization surgery more cautiously than usual moyamoya disease. The possibility of unpredictable postoperative ischemic complication should be kept in mind.

보행장애를 주소로 하는 소뇌형 다계통 위축증 환자의 한방 치료 1례 (A Case Report of Multiple System Atrophy in a Cerebellar Ataxia Patient Suffering from Gait Disturbance Treated with Korean Medicine)

  • 우성진;백경민;장우석
    • 대한한방내과학회지
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    • 제37권5호
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    • pp.806-814
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    • 2016
  • Objective: To describe the effect of Korean medicine on gait disturbance in a patient with multiple system atrophy and cerebellar ataxia. Methods: We observed a 75-year-old female patient who had multiple system atrophy and cerebellar ataxia. The patient was treated with Korean medicine, including acupuncture, moxibustion, and herbal medicine (Yukmijihwang-tang-gamibang and Boyanghwano-tang-gamibang) for 38 days. We evaluated the patient with the Korean version of the Berg Balance Scale (K-BBS), the Unified Multiple System Atrophy Rating Scale (UMSARS), and the Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient’s symptoms were improved. The K-BBS score increased from 9 to 19, while the UMSARS score decreased from 16 to 12 in Part I, from 15 to 7 in part Ⅱ, and from 4 to 3 in part Ⅳ. The NRS-11 score of gait disturbance decreased from 10 to 5. Conclusions: Korean medicine may be an effective treatment for gait disturbance in multiple system atrophy with cerebellar ataxia.

Stroke after percutaneous transhepatic variceal obliteration of esophageal varix in Caroli syndrome

  • Lee, Yoo Min;Lee, Yoon;Choe, Yon Ho
    • Clinical and Experimental Pediatrics
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    • 제56권11호
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    • pp.500-504
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    • 2013
  • Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

Disc Bulging과 Stenosis 소견을 보인 요각통 환자를 대상으로 보존적 치료와 굴곡신정법(屈曲伸延法)을 병용한 치험 1례 (The Clinical Report on 1 case of Low Back Pain and radiational pain Patient Treated by Chuna Traction and Conservative Treatment)

  • 강만호;김수용;이진호;고동현;송우섭
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.1-9
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    • 2006
  • The purpose of this report is to investigate the clinical application of conservative treatment to a patient who has the low back pain and radiational pain. In this case, a female patient, 67 years old, who had low back pain and radiational pain on the right leg. We treated the patient with conservative treatment (acupuncture, herbal medicine, moxibustion) and chuna traction. In result, the in-patient's pain has decreased and walking distance has increased from 10m to 300m for 27 days. In conclusion, conservative treatment and chuna traction could be effective methods to treat the patient who has low back pain and radiational pain.

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요관결석 쇄석술 후 심한 혈뇨 소견을 보인 환자 임상증례 (A Clinical Case Report of Severe Hematuria Patient after Ureterolith Lithotripsy)

  • 이상현;정주용;조명래
    • Korean Journal of Acupuncture
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    • 제32권3호
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    • pp.144-150
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    • 2015
  • Objectives : The purpose of this study is to report the improvement after the Korean medical treatment about a severe hematuria patient after ureterolith lithotripsy. Methods : This study was carried out on 60 year-old female patient who suffered from severe hematuria. We diagnosed a severe hematuria patient after ureterolith lithotripsy as kidney deficiency and blood deficiency pattern in the symptom-differentiation system of Korean medicine and applied herbal medicine, acupuncture and moxibustion to the patient. Results : After Korean medical treatment, we observed improvement of the symptom process by Numeric Rating Scale (NRS), hematologic findings and urinalysis. Blood count of blood and urine had been in the normal range, and NRS of three symptoms had dropped below 0.5. Conclusions : We concluded that Korean medical treatment was an effective treatment for a hematuria patient after ureterolith lithotripsy.

티 트리 오일(Melaleuca Alternifolia)을 이용한 아로마 테라피(Aroma Theraphy) 위주의 한방치료로 호전된 소아 심상성 사마귀 치험1례 (A Case Of Verruca Vulgaris In A Paediatric Patient Treated With Aroma Therapy-Based Korean Medicine By Tea Tree Oil(Melaleuca Alternifolia))

  • 임희영;윤화정;고우신
    • 한방안이비인후피부과학회지
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    • 제33권3호
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    • pp.162-170
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    • 2020
  • Objectives : This study is to report a case of Verruca vulgaris in a paediatric patient, treated with korean medicine, primarily focused on Aroma Therapy by Tea Tree Oil(Melaleuca Alternifolia). Methods : A 12-year-old female patient was treated with herbal medicine, Aroma therapy using Tea tree oil due to periungual and plantar warts. photographs of lesions and VAS were used to evaluted the changes in symptoms. Results : The herbal medicine was performed only for first 7Days due to refusal of the patient. So, the patient was treated by only aroma therapy using tea tree oil for about 9 months. After the treatment, the lesions of the patient showed complete clearence and there was no relapse. Conclusions : This case suggests that Korean medicine, especially aroma therapy using tea tree oil is an effective treatment for Melaleuca Alternifolia.

D.I.T.I.로 관찰한 봉약침요법의 거위발 점액낭염 환자 치험례 (Case Report of Pes Anserine Bursitis patient treated with Bee Venom Acua-Acupuncture Therapy by Using DITI)

  • 김강;임진강;왕오호;장형석;문자영
    • 대한약침학회지
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    • 제7권1호
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    • pp.101-106
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    • 2004
  • Objective : The purpose of this study is to report the effect of Bee Venom Acua-Acupuncture Therapy to the patient of Pes Anserine Bursitis by using DITI. Patient & Methods : The patient was 60-year-old woman who complained severe knee pain. She was treated by bee venom acuaacupuncture therapy. To estimate the efficacy of tratment, we used DITI, visual analog scale, knee joint check(ROM). Results : In this case, we treated patient of Pes Anserine Bursitis for 28 days. bee venom acua-acupuncture therapy efficiently relieved patient's pain and improved ROM. DITI and Visual analog scale also showed significantly valuable changes.

산후 갑상선염 진단을 받은 산후신통(産後身痛) 환자 치험 1례 (A Case Report of Sanhupung Patient Diagnosed of Postpartum Thyroiditis)

  • 김미림;김윤상;임은미
    • 대한한방부인과학회지
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    • 제25권4호
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    • pp.125-133
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    • 2012
  • Objectives: Postpartum thyroiditis patient's symptoms are very similar to symptoms of postpartum disease which can be called sanhupung. This study is to report the effect of herbal medicine on sanhupung patient diagnosed of postpartum thyroiditis. Methods: We treated a 32-year-old female patient who had symptoms of postpartum thyroiditis and sanhupung with Jaeumganghwa-tang and Jayumkeonbi-tang. Results: After herbal medicine treatment the symptoms of postpartum thyroiditis such as general weakness, hot flush on the palms and soles of the feet, fever pattern of malaria and symptoms of sanhupung such as arthralgia, depression, imsomnia, sweating were improved. Conclusions: This case report shows that herbal medicine can be used to treat patient with postpartum thyroiditis and Jaeumganghwa-tang, Jayumkeonbi-tang is effective for mitigating the symptoms of postpartum thyroiditis. However, patient is still in thyroxine treatment, and additional care is required.

Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report

  • Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • 제34권3호
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    • pp.212-217
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    • 2021
  • Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

Airway foreign body occurs unintentionally during anesthetic management of patient with asthma

  • Cho, Woo Jin;Yun, So Hui;Choi, Yun Suk;Lee, Bang Won;Kim, Mi Ok;Park, Jong Cook
    • Journal of Medicine and Life Science
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    • 제16권2호
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    • pp.43-45
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    • 2019
  • Intraoperative delivery of salbutamol (${\beta}_2$ agonist) through a breathing circuit may be performed in asthma patient. A 28-year-old woman with a history of asthma was diagnosed with chronic sinusitis and bilateral nasal polyps, and an endoscopic sinus surgery was performed. The patient was recommended salbutamol nebulization every 4 hours during the perioperative period because of the risk of asthma attack. At the end of the operation, when salbutamol was sprayed through the tube before extubation and the connector tip went inside the tube during injection. The patient was immediately referred to the pulmonary medicine department for bronchoscopy, where the foreign body was removed safely without any complications. When general anesthesia is performed on a patient who usually uses an inhaler for asthma, caution is required because the tip that connects the inhaler and the breathing circuit can aspirate into the endotracheal tube and enter the lungs when applying the inhaler before waking up the patient.