• 제목/요약/키워드: Old patient

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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.

비정형파킨슨증후군 태음인의 어지럼증과 보행장애 치험례 (A Case-Study of Taeeumin Patient with Atypical Parkinsonian Disorders Having Dizziness and Gait Disturbance)

  • 박지은;김국화;이슬;이용재;이정윤
    • 사상체질의학회지
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    • 제34권3호
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    • pp.69-80
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    • 2022
  • A 52-year-old female diagnosed with Atypical Parkinsonian Disorders (APD) about one year ago suffered from dizziness and gait disturbance. The patient was identified as Taeeumin esophagus-cold lung-dry symptomatology pattern and was treated with Jowisengcheong-tang. The patient's symptoms of dizziness and night sweats were assessed using Global Assessment Scale (GAS). And, the Unified Multiple System Atrophy Rating Scale (UMSARS) and the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) were used to assess the overall function of the patient. The patient's symptoms of dizziness and night sweats were significantly improved, and UMSARS and MDS-UPDRS scores were decreased. This case showed that Sasang constitutional medicine treatment can improve APD symptoms and improve the quality of life of the patient.

분심기음으로 호전된 뇌경색 후 우울증환자 치험 1례 (A Case Report of Post-stroke Depression Patient Using Bunsimgi-eum(Fenxingiyin))

  • 류호선;안효진;박세진
    • 대한중풍순환신경학회지
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    • 제13권1호
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    • pp.86-94
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    • 2012
  • Object : The purpose of this case report is to show an efficacy of Bunsimgi-eum(Fenxingiyin) for patient with Post-stroke Depression. Methods : This Patient was 64 year-old man who was diagnosed with Stroke by Brain MRI. And after the stroke, the patient showed some Post-stroke depression(PSD) behaviors, like mutism, waxy flexibility and have no willness of rehabilitation. He was treated by Herbal medicines, acupunctore and moxibustion therapy. 40 days after hospitalization, Bunsimgi-eum was prescribed to the patient. Results : After Bunsimgi-eum Herbal treatment, the symtoms of Post-stroke depression have improved remarkably. The grade of Rt. side hemiparesis and time of rehabilitation treat were also increased. Conclusions : This study suggests that Bunsimgi-eum could have a positive efficacy for Post-stroke depression. As a result, it makes the patient to take more rehabilitation treatment.

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1인실과 다인실 입원 병상 이용에 관한 병상 선택 요인과 환자 만족도 분석 (Use of Single Bedrooms versus Multiple Bedrooms: Selection Factors and Comparison of Patient Satisfaction)

  • 이근찬
    • 한국병원경영학회지
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    • 제26권3호
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    • pp.68-83
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    • 2021
  • Background: It is widely acknowledged that single bedrooms have many potential advantages compared to multiple bedrooms. However, Korea has a reimbursement system that patients have to pay the additional fee if they will use single bedroom or pay-bed (1-3 bedroom). There is little research on patients' bed selection and relationship between patient satisfaction and bed type in the Korean setting. Methods: Using the 2017 Korea Health Panel (KHP) Survey data, we modified bed type by two dichotomous variables: single bedroom vs. multiple bedroom (2+ bedrooms) and pay-bed (1-3 bedroom) vs. reimbursed bed (4+ bedroom). Multivariate logistic regression is performed to determine the factors affecting the patient's choice of room types. Multivariate regression analysis was conducted to examine how hospital room types are affecting patient satisfaction. Results: Single room and pay-bed (1-3 bedroom) use was influenced by patient age (19- years old), male, a person at work, hospitalizing in a clinic, and birth. After controlling variables of the behavioral model of medical utilization, the association between patient satisfaction and use of single bedroom & pay-bed (1-3 bedroom). Cause of hospitalization, major treatment, and recognition of unnecessary care are statistically significant variables on patient satisfaction. Conclusion: Although the single room is about the standard for newly built hospitals in western countries, it remains unclear that single room or pay-bed (1-3 bedroom) has positive effects on patient's outcomes and satisfaction. In this empirical study, the difference in patient satisfaction by bedroom type was not noticeable. In terms of bed management by hospital staff, securing patient credibility in hospital care is an important task. Patients' perception of whether medical staffs have encouraged unnecessary treatment or tests has a significant impact on patient's satisfaction.

심실 중격 결손과 동맥관 개존증을 동반한 아이젠멩거 증후군 환자에서의 심장-폐이식 수술 -1예 보고- (Heart-Lung Transplantation in a Patient with VSD, PDA and Eisenmenger′s Syndrome)

  • 홍유선;김도형;함석진;이교준;이두연;권혁문;김형중;조상호;백효채
    • Journal of Chest Surgery
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    • 제36권6호
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    • pp.418-421
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    • 2003
  • 심장-폐이식은 현재 선천성 심장 질환에 의한 이차성 폐동맥 고혈압 환자에서 최종적 치료로 알려져 있다. 본 41세 남자 환자는 동맥관 개존증에 의한 이차성 페동맥 고혈압으로 진단되었으며 심도자 검사 결과 대동맥압 130/80 mean 100 mmHg, 폐동맥 130/80 mean 109 mmHg, 우심실 130/20 mmHg, 우심방 mean 20 mmHg이었고 우측 폐동맥의 직경이 7.5 cm로 심한 확장소견이 있어 심폐이식을 필요로 하였다. 장기 공여자는 24세 남자 환자로 교통사고에 의해 뇌 경막하 출혈로 타 병원에서 뇌사 판정을 받았다. 수술은 심폐 바이페스하에 동맥관 개존증을 결찰하고 심폐이식술을 시행하였다. 수술 후 1일째 호흡기를 이탈하였으며 3일째 일반 병실로 전원되었고 33일째 퇴원하였으며 41일째 시행한 심근과 폐 조직 검사 소견에서 거부 반응은 없었다.

협간극과 상악동에서 발생한 신경초종 : 증례보고 (Schwannoma in the maxillary sinus and buccal space: Case report)

  • 최병환;박수원;손장호;조영철;성일용;변기정;김영민
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권6호
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    • pp.494-498
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    • 2009
  • Schwannomas are tumors which originate from the neuroectodermal Schwann cell of cranial, intraspinal, peripheral and autonomic nerve sheaths, and they are solitary, benign, slow growing and well encapsulated neoplasm. Schwannomas are usually asymptomatic. No strong gender or age predominance exists. The incidence of extracranial schwannomas in the head and the neck region varies from 25~45%. In addition, schwannomas are rare in the maxillary sinus or buccal space. In this paper, it diagnosed and treated a 54-years old female patient, who had schwannoma in the maxillary sinus derived from infraorbital nerves, the branch of the left trigeminal nerve, and a 19-years old male patient, who had schwannoma arose in the buccal space derived from the buccal branch of the right facial nerve. There was no particular complication except sensory extinction of the nerve in the female patient and paralysis by the nerve in the male patient. It is determined those two cases of schwannoma in the rare portion is valuable and herein, it reports those with literature discussions.

한방처치를 통한 Methicillin내성 포도구균 감염의 음성화 및 약독화 2례 (Two Attenuated Cases of Methicillin-Resistant Staphylococcus aureus Infection Treated by Oriental Internal Medicine)

  • 고창남;윤성우;박성욱;이형철;이상욱
    • 대한한방내과학회지
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    • 제23권2호
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    • pp.298-305
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    • 2002
  • These cases were performed on the bases of clinical consideration about patients who had Methicillin-Resistant Staphylococcus aureus(MRSA) infection. One patient was a 67-years-old women who had sequela of inter cranial hemorrhage & inter ventricular hemorrhage, hypertention, urinary tract infection and pneumonia. Clinical symptoms were intermittent fever, sputum, Lt. side hemiparesis and dysphagia. She was chronic, repeated infection state. It could be regarded as "unpreparedness of the spirit which animates and controls the universe; 正氣虛", the oriental term which indicates a condition of chronic disease or general weakness. According to the oriental medicine principle, oriental medicine was taken such as Wunggunza-tang(六君子湯) and the patient had taken a turn for the better. After 3 months, MRSA infection diappeared. The other patient was a 43-years-old women who had Both brain stem infarction, Lt. cerebellar infarction, hypercholesterolemia, urinary tract infection and pneumonia, Clinical symptoms were quadriplegia, dysphagia(levin tube insert state), aphasia, respiration disorder(tracheostomy cannular keep state) and sputum. She was chronic, repeated infection state. It could be regarded as "unpreparedness of spleen energy, unpreparedness of both energy and blood; 脾氣虛, 氣血兩虛", the oriental term which indicates a condition of chronic disease or immunodeficiency. According to the oriental medicine principle, oriental medicine was taken such as Bojungyggi-tang(補中益氣湯), Palmul-tang(八物湯) and the patient had taken a turn for the better. After I month, MRSA was turned into Escherichia coli.

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근골격계질환자의 양.한방 외래 의료이용과 관련요인 (The Utilization of Western and Oriental Medical Services by Outpatients with Musculoskeletal System Disorders and Its Related Factors)

  • 김성영;박재용
    • 보건의료산업학회지
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    • 제6권1호
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    • pp.27-38
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    • 2012
  • This study is to find out the correlation among the predisposing, enabling, and need factors in Anderson Behavioral Model using the data from Korea Medical Panel Survey conducted in the early part (April 1 - October 31) of 2008. The findings are as follows. It was found that the utilization rate of western medical service was far higher. the influential factor to choose western or oriental medical service taking western medical institutions as the reference group, the influential factor to choose oriental medical institution has significantly increased when the patient who have covered by medical insurance has one accompanied disease and their age was between 45 - 74, compared to the people less than 45 years old. It also increased when the age of the patient was between 45-54 years old, and in the event those who are not covered by medical insurance have accompanied disease and that the disease mobility period is 2-4 years. reviewing the several characteristics of the utilization of western and oriental medical services by the patient with musculoskeletal system disorders, the number of accompanied disease is an influential factor for the utilization of oriental medical services. And, disease mobility period is a significant factor for the utilization of both western and oriental medical services together, though it is not identified in this study. Therefore, it is expected that mutual cooperation between western and oriental medical services is more required for the patient with musculoskeletal system disorders as the aging society rapidly develops. In order to foster oriental medicine, it is required to specialize in competitive disease such as musculoskeletal system disorders.

거대 폐기포 (giant bulla)로 오진된 국소형 긴장성 자발 기흉 (A Case of the Localized Tension Pneumothorax Mimicking Giant Bullae)

  • 고혁;박성오;김수희;박완;박종빈;김종욱;류대식;정복현
    • Tuberculosis and Respiratory Diseases
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    • 제50권6호
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    • pp.740-746
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    • 2001
  • Background : A 35-year-old woman was admitted to the emergency room with sudden dyspnea that developed one day prior. The initial Chest X-ray showed multiple bullous changes at the right middle and lower lung field and long standing fibrotic tuberculous changes at the right upper lung field. The left lung field was totally collapsed by an fibrotic old tuberculous lesion. In spite of supportive medical care with oxygen therapy after admission, the radiographic lesions were no significant change but the respiratory distress had worsened. The patient suffered respiratory failure and received mechanical ventilatory support. The HRCT showed a localized tension pneumothorax mimicking multiple giant bullae at the right lower lung field. Immediately after a closed thoracostomy with a 32 French chest tube and air drainage, her vital signs and dyspnea were gradually improved. The patient was successfully weaned from mechanical ventilation after 5 days of mechanical ventilatory support. The patient had received talc pleurodesis through a chest tube to prevent the recurrence of the life-threatening localized pneumothorax. The patient was discharged without recurrence of the pneumothorax.

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Forehead reconstruction with a custom-made three-dimensional titanium implant in a Parry-Romberg syndrome patient

  • Kim, Jae Yoon;Jung, Bok Ki;Kim, Young Suk;Roh, Tai Suk;Yun, In Sik
    • 대한두개안면성형외과학회지
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    • 제19권2호
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    • pp.135-138
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    • 2018
  • Parry-Romberg syndrome is a rare neurocutaneous syndrome characterized by progressive shrinkage and degeneration of the tissues usually on only one side of the face. It is usually difficult to restore the facial contour due to skin tightness. In this case report, we report a forehead reconstruction with custom-made three-dimensional (3D) titanium implant of a Parry-Romberg syndrome patient who was treated with multiple fat grafts but had limited effect. A 36-year-old man presented with hemifacial atrophy. The disease progressed from 5 to 16 years old. The patient had alopecia on frontal scalp and received a surgery using tissue expander. The alopecia lesion was covered by expanded scalp flap done 22 years ago. Also, he was treated with fat grafts on depressed forehead 17 years ago. However, it did not work sufficiently, and there was noted depressed forehead. We planned to make 3D titanium implant to cover the depressed area (from the superior orbital rim to the vertex). During the operation, we confirmed that the custom-made 3D implant accurately fit for the depressed area without any dead spaces. Previously depressed forehead and glabella were elevated, and the forehead contour was improved cosmetically. A custom-made 3D titanium implant is widely used for skull reconstruction and bring good results. In our case, the depressed forehead of a Parry-Romberg syndrome patient was improved by a 3D titanium implant.