• 제목/요약/키워드: Old patient

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액와 개흉술에 의한 기흉수술시 발생한 상완신경총 손상 (Brachial Plexus Injury after Wedge Resection by Axillary Thoractomy)

  • 김동원
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.328-330
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    • 1994
  • Brachial plexus injury developing after axillary thoracotomy is an uncommon complication. But if it occurs, it may cause annoying events. We recently experienced 2 patients who developed brachial plexus injury after wedge resection by axillary thoracotomy . The first patient was a 22 year-old man with right spontaneous pneumothorax . After wedge resection of the right upper lung by axillary thoracotomy, he complained total paralysis of the right arm. An electromyogram was obtained at 7 days after operation, with the confirmation of brachial plexus injury. He was discharged at 22days after operation and brachial plexus injury was completely recovered 4 months after discharge. The second patient was a 17 year-old man with recurrent right pneumothorax. He underwent wedge resection of the right upper lung by axillary thoracotomy. Electromyogram confirmed the diagnosis of brachial plexus injury in the immediate postoperative period. He was discharged at 15 days after operation and brachial plexus injury was recovered 2months after discharge.Brachial plexus injury after axillary thoracotomy is caused by stretching around the clavicle and tendon of pectoralis minor by fixation of the abducted arm to the frame. Thus, when we perform wedge resection by axillary thoracotomy, we must avoid over-stretching of the brachial plexus in positioning. If brachial plexus injury develops, immediate attention and management with close rapport are important to avoid possible medicolegal problems.

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식도와 폐의 동시성 중복암 -2예 보고 - (RVOTO Caused by Pulmonary Artery Sarcoma Originating from Pulmonary Valve -Two case report-)

  • 김대현;이인호;윤효철;김수철;김범식;조규석;박주철
    • Journal of Chest Surgery
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    • 제37권2호
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    • pp.184-187
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    • 2004
  • 식도와 폐에 동시성 중복암이 발생하는 경우는 드물다. 우폐 하엽과 흉부 식도에 원발성 편평상피세포암이 발생한 75세 남자 환자에 대해 우폐 하엽 절제술과 Ivor Lewis 술식을 동시에 시행하였다. 좌폐 상엽의 편평상피세포암으로 좌폐 상엽 절제술을 시행했던 69세 남자 환자에서 4개월 후 흉부 식도에 발생한 편평상피세포암에 대해 Ivor Lewis 술식을 시행하였다. 상기 2명의 환자는 수술 후 각각 10개월, 24개월째이며 재발 없이 잘 지내고 있다. 저자들은 식도와 폐에 발생한 동시성 중복암 2예에 대해 완전 절제를 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

사회변화에 따른 소방의 역할증대 개선방안에 관한 실증적 연구 (Positive Study for the Method of Improving the Role of Fire Fighting with Social Change)

  • 강창곤
    • 한국화재소방학회논문지
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    • 제20권3호
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    • pp.85-95
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    • 2006
  • 경제성장과 의학의 발달로 인간의 평균수명이 연장되면서 노인인구가 크게 증가하였다. 노인인구가 증가함에 따라 응급환자에 대한 구급수요도 증가하였다. 이에 소방에서는 현재시범운행중인 실버 앰뷸런스의 확대배치와 병원의료진과 119의 합동체제 구축 및 노인의료관련 교육과정의 신설과 이미 독거 노유자에게 설치 운영중인 무선페이징 시스템의 문제점등을 개선하여 시스템의 기능 향상과 운영의 효율화를 이루고 더 나아가 노인을 위한 전용자원봉사자은행등을 설치 이를 연계한 실버세대에 대한 토털 서비스를 통하여 119업무를 확대해 나감으로써 신뢰받고 사랑받는 소방조직으로 거듭날 수 있을 것이다.

정신지체 환자에서 외래전신마취 하 치과치료 후 발생한 폐렴 -증례보고- (Pneumonia after Dental Treatment under Ambulatory General Anesthesia in Mentally Retard Patient -A Case Report-)

  • 서광석;장주혜;신터전;이영은;김현정
    • 대한치과마취과학회지
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    • 제8권2호
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    • pp.122-126
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    • 2008
  • A 15-years-old female patient with seizure disorder and pervasive developmental disorder was scheduled for dental treatment under ambulatory general anesthesia. She had past history of pneumonia and herpes encephalitis when she was 3 year old. Because of sever mental retardation and behavior disorder, routine laboratory test was substituted with physical exam and medical records of department of pediatrics. A few days before general anesthesia, she showed slight common cold, but pediatric consult had reported that there was minimal risk in general anesthesia. After 4-hour general anesthesia, she became critically sick with high fever, cough and malaise. After 10-day hospitalization with pneumonia and sepsis, she could go home.

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Hereditary protein S deficiency presenting acute pulmonary embolism

  • Kim, Jiwan;Kim, Sung Hea;Jung, Sang Man;Park, Sooyoun;Yu, HyungMin;An, Sanghee;Kang, Seonghui;Kim, Hyun-Joong
    • Journal of Yeungnam Medical Science
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    • 제31권1호
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    • pp.52-55
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    • 2014
  • Protein S deficiency is one of the several risk factors for thrombophilia and can cause blood clotting disorders such as deep vein thrombosis and pulmonary embolism. A 54-year-old man was admitted with the complaint of dyspnea and was diagnosed with pulmonary embolism. The patient had very low level of free protein S, total protein S antigen, and protein S activity (type I protein S deficiency). In history taking, we found that his mother, 78 year old, had a history of same disease 10 years ago, and confirmed the pronounced low level of protein S. The patient's son also had very low level of protein S, however there had not been any history of pulmonary embolism yet. This case study suggests that asymptomatic persons with a family history of protein S deficiency and pulmonary embolism should be checked regularly for early detection of the disease, as protein S deficiency can be suspected.

Two Cases of Endometrial Cancer Treated with Palliative Herbal Medication Hangam-dan (HAD)

  • Yoo, Hwa-Seung;Kim, Seung-Hyun;Lee, Yeon-Weol;Cho, Chong-Kwan;Lee, Keun-Ho
    • 대한한의학회지
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    • 제28권4호
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    • pp.176-180
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    • 2007
  • Background : Advanced-stage endometrial cancer patients show a poor prognosis because of limited success from surgery, radiotherapy or chemotherapy. Recently, the uses of complimentary and alternative medicines have gained popularity for these patients. Cases : The first case is a 46-year-old patient with FIGO stage IVb endometrial cancer who had distant metastasis on her supraclavicular LNs area; the second, a 72-year-old stage Ib patient who could not be treated with surgery or chemotherapy because of chronic heart disease and her refusal of radiation therapy due to her advanced age. They remain alive and in stable condition under a strict traditional herbal medicine regiment 41 and 52 months, respectively, after diagnosis. Conclusion : We present two cases of endometrial cancer patients who desire to be treated by traditional herbal medication with no further development.

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Epidural Clonidine의 제통효과에 관한 증례 2례 보고 (Two Cases Report of Epidural Clonidine Analgesia in Cancer Patient and in Patient Tolerant to Opioids)

  • 김병중;김영미;권광준;윤영준;진상호
    • The Korean Journal of Pain
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    • 제7권2호
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    • pp.282-286
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    • 1994
  • The central antihypertensive agent clonidine is an ${\alpha}_2$-adrenergic agonist that possesses pain-relieving properties. It has been administered epidurally in the treatment of cancer pain and for postoperative analgesia. 1) Case 1, 62-year-old woman who suffered from neurogenic pain syndrome due to metastatic squamous cell carcinoma of spinal canal was treated. 2) Case 2, 51-year-old woman undergoing lower abdominal surgery, epidurally administered morphine did not produced postoperative analgesia. In these cases, continuous epidural administeration of clonidine (200ug/day) and 0.3% bupivacaine(12 ml/day) produce high quality pain relief. These results suggest that antinociceptive effect of epidural clonidine is assumed to result from activation of ${\alpha}_2$-adrenergic receptors in the dorsal horn of the spinal cord.

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매핵기(梅核氣)로 인해 음식을 삼키지 못하는 전환장애 환아 치험 1례 (A Case Report of Conversion Disorder Patient with Globus Hystericus and Swallowing difficulty)

  • 황은영;서진우;서현욱;정선용;김종우
    • 동의신경정신과학회지
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    • 제20권2호
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    • pp.197-206
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    • 2009
  • Objective : This study was designed to research the effect of the korean traditional herbal medicine and oriental psychotheraphy on globus hytericus and swallowing difficulty caused by conversion disorder. Methods : A 10 years old male patient suffer from globus sensation and swallowing difficulty for 2 months. We treated him with the korean traditional herbal medicine(Banhahubak-tang) and oriental psychotheraphy for 27 days. Results : After this treatment, globus sensation and swallowing difficulty were decreased and appetite were increased. In addition, compulsion had been severe and it was improved after this treatment. Conclusions : Psychiatrists have reported that conversion disorder is not common in children especially under 10 years old. Globus hystericus, dysphagia is symptoms of conversion disoder but globus hystericus is very rare in childhood. In this case, we recognized that the korean traditional herbal medicine and oriental psychotheraphy could be effective for the clinical symptoms of globus hystericus and swallowing difficulty.

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후두암 절제 수술후 발생한 2차성 폐암 수술치험(2예) (Secondary Primary Lung Carcinoma after Total Laryngectomy Due to Laryngeal Carcinoma)

  • 노환규
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.98-105
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    • 1991
  • There have been reports concerning the association of laryngeal carcinoma and lung cancer. Second primary respiratory tract malignancies occur frequently in patients who have undergone the treatment of laryngeal cancer probably because they are exposed to the same carcinogen. Recently, we have experienced two patients who developed second primary lung cancer 30 and 41 months after the first diagnosis of laryngeal cancer at the Department of Thoracic & Cardiovascular Surgery, Yonsei University College of Medicine. Relative long interval between the two carcinomas indicated metastasis unlikely. From a therapeutic standpoint, it is of great importance that they should be regarded as separate primaries and not as metastasis. Longevity will depends on a presumption that the lesions are separate primaries and the status of stage at the time of detection of second primary lesion. The follow-up of patients who are seen with carcinomas of the head and neck should be done at regular interval and include a chest roentgenogram and cytologic examination of sputum to detect early changes before the tumors becomes incurable. The first 76 year old patient with left upper lobectomy due to the T2N0M0 lung cancer has been in good condition to present. But the second 55 year old patient with right pneumonectomy due to the T2N0M0 lung cancer died of respiratory failure and septic pneumonia 3 months after operation and chemotherapy.

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알레르기성 자반증(紫斑證)의 증례 보고 2례 (Study of Two Cases for Allergic Purpura)

  • 김자혜;윤화정
    • 동의생리병리학회지
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    • 제19권3호
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    • pp.821-825
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    • 2005
  • A boy who was eight years old visited the Dept. of Oriental Medical Ophthamology & Otolaryngology & Dermatology Hospital, Dongeui University with allergic purpura. He was suffering from the purpuric rash occurring on the lower extremities and the edema of leg. We treated a patient with only Oriental Medicine(a internal use of the herbal medicine, Dangguisusangamibang and a acupuncture). After four days or so, the symptom of the skin disease was recovered remarkably. The second case, a different boy who was ten years old visited the same hospital with allergic purpura. He was suffering from the purpuric rash occurring on the lower extremities, too. We also treated a patient with only Oriental Medicine(internal use of the herbal medicine, Dangguisusangamibang and a acupuncture). After one weeks or so, the symptom of the skin disease was improved remarkably, we think that these are good cases to treat with Oriental Medicine, Dangguisusangamibang. We suggest that the Oriental Herb medicine, Dangguisusangamibang have an effect with allergic purpura which means Podoyug in Oriental medicine.