• 제목/요약/키워드: One-year mortality

검색결과 346건 처리시간 0.025초

Local anesthesia of the temporomandibular joint to reduce pain during mouth opening for dental treatment in a patient with spinal muscular atrophy

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk;Lee, Jong Ho;Chang, Juhea
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권2호
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    • pp.137-140
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    • 2016
  • Spinal muscular atrophy (SMA) is an autosomal recessive, severe neuromuscular disorder in which degeneration of alpha motor neurons in the spine progressively weakens and ultimately paralyzes the proximal muscles. It occurs in one per 6,000-10,000 infants, and is a genetic disorder with the second-highest mortality rate worldwide. An 18-year-old male patient with SMA was referred for general anesthesia for difficulty in performing dental treatment due to limited mouth opening caused by temporomandibular joint (TMJ) pain. However, the patient had a high risk of general anesthesia complications, so TMJ pain during mouth opening was reduced through local anesthesia of the TMJ. Fortunately, the anesthesia was successful in reducing pain during mouth opening, enabling the patient to receive dental treatment with an adequate mouth opening.

폐실질내 골절된 늑골의 합입에 의한 대량각혈 (Massive Hemoptysis Due to Impaction of Fractured Rib into the Lung Parenchyme - 1 Case Report -)

  • 이용재
    • Journal of Chest Surgery
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    • 제25권7호
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    • pp.711-715
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    • 1992
  • Massive hemoptysis is defined as pulmonary hemorrhage of more than 600ml to 800ml within 24hours. Among the many causes, the most common include pulmonary tuberculosis, abscess, bronchiectasis, cystic fibrosis bronchial carcinoma. Most acute episodes of hemoptysis last less than 24 hours and gradually subside. However, when the hem-optysis is massive, it carries a mortality rate of 50% to 100%. It is generally agreed that surgery is the treatment of choice for patients with massive hemoptysis. We had the one case of 39 year-old male with recurrent massive hemoptysis. In the past history, he had pulmonary tuberculosis 20 years ago but no chest trauma, Previous chest CT showed well defined cavitary lesion with calcification on RUL Under the bronchoscope finding, we indentified active bleeding from right upper lobe bronchus without end-obronchial lesion. Therefore, emergency thoracotomy was done with impression of hem-optysis due to pulmonary tuberculosis. But operative findings were as follows ; the 4th fractured rib was impacted into the lung parenchyme with severe adhesion and middle lobe was not inflated. So, Upper and middle lobectomy were performed. He was diagnosed finally by operative and pathological findings as massive hemoptysis due to impaction of fractured rib into the lung parenchyme and discharged without complication.

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신증후군에서 의료방임으로 발생한 복부농양 1례 (A Case of Peritoneal Empyema in a Patient with Nephrotic Syndrome due to Medical Neglect)

  • 신윤혜;허준;이강균;임현이;배기수
    • Childhood Kidney Diseases
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    • 제9권1호
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    • pp.108-111
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    • 2005
  • 세균성 복막염은 신증후군 환아의 생명을 위협하는 중요한 감염성 합병증으로 초기에 광범위한 항생제 병용치료가 이루어져야한다. 저자들은 신증후군 진단 후 치료가 지연된 환아에서 발생한 복막염 및 복부농양 증례를 경험하였기에 보고하는 바이다.

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폐와 입술의 이중 원발암을 가진 환자에서 손가락 끝으로의 전이 1례 (A Case of Finger Tip Metastasis in Patient with Double Primary Cancer of Lung and Lower Lip)

  • 안건형;송진경;주홍실;임성윤
    • 대한두경부종양학회지
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    • 제32권2호
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    • pp.69-72
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    • 2016
  • Lung cancer is one of high mortality malignancy. It is known that skin metastasis from lung cancer is uncommon. We report a very rare case of finger tip metastasis from double primary cancer of the lung and lower lip. A 79 year-old man diagnosed with non small cell lung cancer presented with protruding solid mass in his lower lip. It showed central necrosis with purulent discharge. It had appeared rapidly growing features. Simultaneously, another solid mass accompanying painful swelling without skin lesion was found in his left middle finger tip. Both two solid masses were moderately differentiated squamous cell carcinomas. Lower lip mass was a primary cancer, while middle finger tip mass was diagnosed with clinically metastatic cancer from lung or lower lip, which means that it had double primary cancer origin.

Improved Classification of Cancerous Histopathology Images using Color Channel Separation and Deep Learning

  • Gupta, Rachit Kumar;Manhas, Jatinder
    • Journal of Multimedia Information System
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    • 제8권3호
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    • pp.175-182
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    • 2021
  • Oral cancer is ranked second most diagnosed cancer among Indian population and ranked sixth all around the world. Oral cancer is one of the deadliest cancers with high mortality rate and very less 5-year survival rates even after treatment. It becomes necessary to detect oral malignancies as early as possible so that timely treatment may be given to patient and increase the survival chances. In recent years deep learning based frameworks have been proposed by many researchers that can detect malignancies from medical images. In this paper we have proposed a deep learning-based framework which detects oral cancer from histopathology images very efficiently. We have designed our model to split the color channels and extract deep features from these individual channels rather than single combined channel with the help of Efficient NET B3. These features from different channels are fused by using feature fusion module designed as a layer and placed before dense layers of Efficient NET. The experiments were performed on our own dataset collected from hospitals. We also performed experiments of BreakHis, and ICML datasets to evaluate our model. The results produced by our model are very good as compared to previously reported results.

Seven-year Survival Rate of On-line Hemodiafiltration

  • Yoon, Jung-Hwan;Kim, Nam-Ho
    • 대한의생명과학회지
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    • 제25권1호
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    • pp.32-39
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    • 2019
  • Conventional high-flux hemodialysis (HD) is not as good as normal kidney function. Morbidity and mortality rates of patients receiving HD are still very high. To increase mid-to-large molecule clearance by combining diffusion and convection, on-line hemodiafiltration (HDF) is required. The objective of this study was to compare long-term survival rate of patients treated with on-line HDF to those who received conventional high-flux HD by reviewing data from Chonnam National University Hospital (CNUH). We selected patients who attended the 'CUNH dialysis center' and agreed to participate in the study. Overall, 40 patients with ESRD switched from high flux HD to on-line HDF or started on-line HDF from August 2007 to December 2009. Additionally, a total of 42 patients receiving conventional high-flux HD during the same period were enrolled. We then reviewed long-term survival rate of patients receiving on-line HDF over the next seven years. When we compared survival rates for seven years, the survival rate of the group receiving on-line HDF was 65% (26/40) while that of the group receiving the conventional high-flux HD was 54.8% (23/42). Although the number of patients was small to see survival difference clearly by one specific dialysis modality, there was somewhat difference in survival rate between the two groups. Indicators such as anemia, calcium-phosphate metabolism, nutritional status, treatment adequacy, and hospitalization were also improved in the group receiving HDF. Overall, results of our study showed beneficial effects of on-line HDF on clinical outcomes and survival in chronic HD patients.

A Case Series of Ingested Open Safety Pin Removal Using a Proposed Endoscopic Removal Technique Algorithm

  • Demiroren, Kaan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권5호
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    • pp.441-446
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    • 2019
  • Purpose: Safety pin ingestion is common in some regions of the world and may lead to severe morbidity and mortality. The aim of this study was to present some practical suggestions for ingested safety pins using an accompanying algorithm, presented for the first time in the literature to the best of our knowledge. Methods: Twenty children with ingested safety pins during a 4-year period were retrospectively included in the study. Results: Median age of patients was 9.5 months (interquartile range, 6.3-14 months), and 70% were girls. On endoscopic examination, safety pins were observed in the stomach (25%), duodenal bulb (20%), upper esophagus (15%), middle esophagus (10%), and second part of the duodenum (10%) but were not observed in 20% of the cases. Safety pins were removed using endoscopy in 15 cases (75%). In four cases (20%), no safety pin was observed on endoscopic examination. In one case (5%) involving a 6-month-old infant, the safety pin could not be removed although it was observed using endoscopy. No surgical intervention was needed for any patient. No complications such as perforation or deaths developed, except for erosions, due to the foreign body removal procedure. Conclusion: Safety pins are easily removed endoscopically. The best option is to remove the safety pin using endoscopy while it is still in the esophagus and stomach. For this reason, endoscopic procedures should be performed as soon as possible in children who have ingested safety pins.

Simulation and validation of flash flood in the head-water catchments of the Geum river basin

  • Duong, Ngoc Tien;Kim, Jeong Bae;Bae, Deg-Hyo
    • 한국수자원학회:학술대회논문집
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    • 한국수자원학회 2021년도 학술발표회
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    • pp.138-138
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    • 2021
  • Flash floods are one of the types of natural hazards which has severe consequences. Flash floods cause high mortality, about 5,000 deaths a year worldwide. Flash floods usually occur in mountainous areas in conditions where the soil is highly saturated and also when heavy rainfall happens in a short period of time. The magnitude of a flash flood depends on several natural and human factors, including: rainfall duration and intensity, antecedent soil moisture conditions, land cover, soil type, watershed characteristics, land use. Among these rainfall intensity and antecedent soil moisture, play the most important roles, respectively. Flash Flood Guidance is the amount of rainfall of a given duration over a small stream basin needed to create minor flooding (bank-full) conditions at the outlet of the stream basin. In this study, the Sejong University Rainfall-Runoff model (SURR model) was used to calculate soil moisture along with FFG in order to identify flash flood events for the Geum basin. The division of Geum river basin led to 177 head-water catchments, with an average of 38 km2. the soil moisture of head-water catchments is considered the same as sub-basin. The study has measured the threshold of flash flood generation by GIUH method. Finally, the flash flood events were used for verification of FFG. The results of the validation of seven past independent events of flash flood events are very satisfying.

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일개 공공병원 응급실 방문건수 관련 요인 (Factors affecting the number of emergency room visits in a public hospital in Korea)

  • 양병근;오재환;이광수
    • 한국병원경영학회지
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    • 제28권3호
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    • pp.39-46
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    • 2023
  • Purpose: Korean medical services are not balanced across regions and social classes. To prevent mortality gaps, Korea must distribute its medical resources more efficiently. Patient factors affecting emergency room visits serve as basic data for determining best practices for public healthcare distribution. Methods: The data included 18 473 visits by 14 949 de-identified patients who visited a public emergency room over one year. The dependent variable was the number of emergency room visits. A Poisson regression was conducted with the independent variables, comprising sociodemographic, socioeconomic, and spatial accessibility factors and patient characteristics. Results: Older men with higher Korean Triage and Acuity Scale scores visited more frequently. Greater patient-hospital distance decreased visits; however, the presence of a hospital within 1 km of a patient's residence did not affect the number of visits. The use of 119 services was negatively correlated with the number of visits. Visits increased with more medical benefits. Conclusions: Patient age, distance to hospital, use of 119 services, and medical benefits should be considered when planning or managing public hospitals in Korea.

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응급실을 통하여 입원한 체간부 관통상 환자에 관한 임상적인 고찰 (Clinical Patterns of Penetrating Torso Injury at Emergency Department)

  • 윤순영;전영진;원태희
    • Journal of Trauma and Injury
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    • 제18권1호
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    • pp.47-52
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    • 2005
  • Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.