• Title/Summary/Keyword: Patient Flow

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Reperfusion Injury after Autologous Cranioplasty in a Patient with Sinking Skin Flap Syndrome

  • Kwon, Sae-Min;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.117-119
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    • 2012
  • The sinking skin flap syndrome is a rare complication after a large craniectomy. It consists of a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. In patient with sinking skin flap syndrome, cerebral blood flow and cerebral metabolism are decreased by sinking skin flap syndrome, and it may cause the deterioration of autoregulation of brain. We report a case of a patient with sinking skin flap syndrome who suffered from reperfusion injury after cranioplasty with review of pertinent literature.

The clinical report of External Gi-Gong Therapy about Pruritus and Erythema (소양(搔痒)과 홍반(紅班)에 대한 기공치료(氣功治療) 증례보고)

  • Bae Hang;Park Ryung-Jun
    • Journal of Korean Medical Ki-Gong Academy
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    • v.7 no.1
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    • pp.127-148
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    • 2003
  • This paper includes five cases about patient with pruritus and erythema by External Gi-Gong Therapy(EKT) for two days. We judged the patient who has pruritus and erythema, and treated them with External Gi-Gong Therapy(EKT). EKT has always been part of the medical Gi-Gong practice. EKT refers to the process by which a Gi-Gong practitioner directs his intention, or emits his Gi energy, to help others break Gi blockages and induce the sick Gi out of the body so as to alleviate the pain, abate the disease, and balance the flow of Gi. We expect that External Gi-Gong Therapy is effective for patient with pruritus and erythema.

An effective emergency care of a person from water submersion (익수사고자에 대한 효과적인 응급처치 방법)

  • Oh, Yong-Gyo;Park, Hyoung-Sun
    • The Korean Journal of Emergency Medical Services
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    • v.2 no.1
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    • pp.26-35
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    • 1998
  • This study was to exhibit the effective emergency care method for the drowning and non-drowning who are reached two-thousand peoples every year in our country. For investigate the effective emergency care, this study was discussed as follows ; Pathophysiology of the water submersion, Fresh-water & sea-water drowning, Factors affecting survival, and Prehospital management. The conclusions from this study were summarized as follows; 1. Remove the patient from the water. If you suspect neck or spinal injuries, Always support the head and neck level with the back and, begin rescue breathing. 2. Maintain the airway and support ventilation in the water use the jaw-thrust technique to avoid farther injury to the neck or spine. We might encounter more resistance to ventilations than you expect because of water in the airway. Once you have determined that there are no foreign objects in the airway, apply ventilations with more force; adjust ventilations until you see the patient's chest rise and fall but not until you see gastric distention. Do not attempt to remove water from the patient's lungs or stomach. 3. If there is no pulse, begin CPR. 4. Administer high-flow supplemental oxygen; suction as needed. 5. Once the patient is breathing and has a pulse, assess for hemorrhage; control any serious bleeding that you find. 6. Cover the patient to conserve body heat, Handle the patient very gently, and, Transport the patient as quickly as possible to Emergency Department, Continuing resuscitative measures during transport. If the patient have the hypothermia, follow hypothermia management.

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Comparison of Objective and Subjective Diagnostic Tests for Assessing Oral Dryness in Healthy Participants

  • Shin, Jun-Hee;Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.46 no.4
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    • pp.109-116
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    • 2021
  • Purpose: Xerostomia is subjective feeling of dry mouth. It is complicated and multifactorial, which burdens clinicians in diagnosis and treatment of the problem. The goal of this study was to discuss the clinical importance of salivary flow rate, pH and subjective symptoms for evaluating oral dryness among young healthy male subjects. Methods: Thirty male participants were recruited in this study (mean age±standard deviation of 25.70±1.84). All participants completed 'Xerostomia Inventory' to measure subjective oral dryness scores. Unstimulated saliva and stimulated saliva were collected from each participant twice a day at 12:00 pm and 5:00 pm, using spitting method. Salivary flow rates and pH were measured immediately after collection. Relationship between objective and subjective measurements were analyzed. Results: There were excellent intra-examiner reliability for salivary flow rate and pH and good internal consistency for Xerostomia Inventory. Objective measurements and subjective symptoms did not exhibit positive association. Salivary flow rate in unstimulated and stimulated condition showed positive association and also for salivary pH. Stimulated salivary flow rate also presented positive correlation with stimulated salivary pH. Conclusions: Comprehensive assessment of objective measurements and subjective symptoms may be complimentary for assessing oral dryness, which would assist in implementing early interventions to improve patient's quality of life.

Compensation of Error in Noninvasive Blood Pressure Measurement System Using Optical Sensor (광학 센서를 이용한 비관혈적 혈압 측정의 오차 보정)

  • Ko, J.I.;Jeong, I.C.;Lee, D.H.;Park, S.W.;Hwang, S.O.;Park, S.M.;Kim, G.Y.;Joo, H.S.;Yoon, H.R.
    • Journal of Biomedical Engineering Research
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    • v.28 no.2
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    • pp.178-186
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    • 2007
  • This study is attempted to correct an error of electronic blood pressure meter with an optical sensor. In general, for a hospitalized patient, ECG, blood pressure, oxygen saturation, and respiration are basically measured to monitor the patient's condition. Opening of a blood vessel after it is occluded by pressurizing the cuff influences the blood flow of peripheral blood vessels as well as oscillation changes in the cuff. Blood vessels are occluded and peripheral blood flow disappears at cuff pressure above the examinee's blood pressure, while blood vessels are opened and peripheral blood flow appears again at cuff pressure under the examinee's blood pressure. Then Disappear-Appear Point Length(DAPL) of peripheral blood flow can be judged with the signal of peripheral blood flow, thus is available as a factor of error correction for electronic blood pressure meter. Also, systolic or diastolic blood pressure can be corrected with Appear-Point-Pressure(APP) of cuff pressure at a point where blood flow occurs and Appear-Maximum Pressure(AMP) of cuff pressure at the maximum amplitude point of peripheral blood flow after peripheral blood flow appears again. For verification, 27 examinees were selected, and their blood value was obtained through experimental procedure of 4 stages including induction of blood pressure change. The examinees were divided into two groups of experimental group and control group, regression analysis was conducted for experimental group, and correction of a blood pressure error was verified with optical signal by applying the regression equation calculated in experimental group to control group. As an experimental result, mean of the whole measurement errors was 5mmHg or more, which did not meet the standard fur blood pressure meter. As a result of correcting blood pressure measurements with data of DAPL, APP, and AMP as drawn out of PPG signal, systolic blood pressure, mean blood pressure, and diastolic blood pressure were $-0.6{\pm}4.4mmHg,\;-1.0{\pm}3.9mmHg$ and $-1.3{\pm}5.4mmHg$, respectively, indicating that mean of the whole measurement errors was greatly improved, and standard deviation was decreased.

Patient-specific surgical options for breast cancer-related lymphedema: technical tips

  • Kwon, Jin Geun;Hong, Dae Won;Suh, Hyunsuk Peter;Pak, Changsik John;Hong, Joon Pio
    • Archives of Plastic Surgery
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    • v.48 no.3
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    • pp.246-253
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    • 2021
  • In order to provide a physiological solution for patients with breast cancer-related lymphedema (BCRL), the surgeon must understand where and how the pathology of lymphedema occurred. Based on each patient's pathology, the treatment plan should be carefully decided and individualized. At the authors' institution, the treatment plan is made individually based on each patient's symptoms and relative factors. Most early-stage patients first undergo decongestive therapy and then, depending on the efficacy of the treatment, a surgical approach is suggested. If the patient is indicated for surgery, all the points of lymphatic flow obstruction are carefully examined. Thus a BCRL patient can be considered for lymphaticovenous anastomosis (LVA), a lymph node flap, scar resection, or a combination thereof. LVA targets ectatic superficial collecting lymphatics, which are located within the deep fat layer, and preoperative mapping using ultrasonography is critical. If there is contracture on the axilla, axillary scar removal is indicated to relieve the vein pressure and allow better drainage. Furthermore, removing the scars and reconstructing the fat layer will allow a better chance for the lymphatics to regenerate. After complete removal of scar tissue, a regional fat flap or a superficial circumflex iliac artery perforator flap with lymph node transfer is performed. By deciding the surgical planning for BCRL based on each patient's pathophysiology, optimal outcomes can be achieved. Depending on each patient's pathophysiology, LVA, scar removal, vascularized lymph node transfer with a sufficient adipocutaneous flap, and simultaneous breast reconstruction should be planned.

Quantitative Evaluation of Appointment System for Outpatients in Dental Clinic (치과의원 외래환자 예약관리체계의 계량적 평가)

  • Lee, Hyung-Ju;Chang, Hye-Jung
    • Korea Journal of Hospital Management
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    • v.8 no.2
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    • pp.49-69
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    • 2003
  • This study purported to evaluate the performance of the appointment system for outpatients in primary care dental clinic. The data of patients' time flow for 1,245 patients in Y Dental Clinic were collected for one month in 2002 and then analyzed. Specifically, the time periods of treatment and patients' waiting as well as rates of appointment and it's failure are estimated. The accuracy of expected treatment time period was also evaluated. The results showed that 72% of patients visited the clinic with appointments, and only 56% kept their appointments. The patient's waiting time period turned out to be 11 minutes in Y clinic. The expected treatment time period is turned out to be very important because they influence significantly on patient's waiting time period. Practically, the expected treatment time period should be overestimated about 9 minutes in general, and the characteristics of dentist, each patient's diagnosis and age need to be especially considered. Hospitals and clinics also need to make the systematic and detailed critical pathways for a variety of patient cases by analyzing the patients' treatment pattern. With the improved appointment systems, healthcare institutions will approach the goal of effective and efficient management of the institution and also satisfy their customers.

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Infusion Pump용 Drop Sensor 개발에 관한 연구

  • Lee, Jong-Sil;Gwon, Jang-U;Lee, Eung-Hyeok;Park, Jeong-Seon;Gu, Ja-Il;Hong, Seung-Hong
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.11
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    • pp.18-21
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    • 1995
  • When we inject drugstuffs to a patient for a long time, it is important to control proper injection amount and flow rate. Since inproper injection amount and a flow rate would cause bad a recovery a patient, the relience of sensors which detect injection amount is an important factor for whole injection systems' performance. In this research, we've compared the suitability of three sensors for injection pump monitoring system. The three types of sensors, piezo film sensor, photo transistor made up with three transmitting photodiodes and receving photodiode, and photo array, were selected for comparing. Using suggested data processing technique and photo amy sensors, we could minimize the effect of interference, disturbance, illumanation change, and sensitivity change caused by sensor's position. According to the experiments, the photo amy showed the higher reliance than any other the three types of sensors. The developed systems could be the foundation of beginning home production of infusion pump system and available for the base model of whole monitoring and control systems.

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Hydrocephalus due to Membranous Obstruction of Magendie's Foramen

  • Kasapas, Konstantinos;Varthalitis, Dimitrios;Georgakoulias, Nikolaos;Orphanidis, Georgios
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.68-71
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    • 2015
  • We report a case of non communicating hydrocephalus due to membranous obstruction of Magendie's foramen. A 37-year-old woman presented with intracranial hypertension symptoms caused by the occlusion of Magendie's foramen by a membrane probably due to arachnoiditis. As far as the patient's past medical history is concerned, an Epstein-Barr virus infectious mononucleosis was described. Fundoscopic examination revealed bilateral papilledema. Brain magnetic resonance imaging demonstrated a significant ventricular dilatation of all ventricles and turbulent flow of cerebelospinal fluid (CSF) in the fourth ventricle as well as back flow of CSF through the Monro's foramen to the lateral ventricles. The patient underwent a suboccipital craniotomy with C1 laminectomy. An occlusion of Magendie's foramen by a thickened membrane was recognized and it was incised and removed. We confirm the existence of hydrocephalus caused by fourth ventricle outflow obstruction by a membrane. The nature of this rare entity is difficult to demonstrate because of the complex morphology of the fourth ventricle. Treatment with surgical exploration and incision of the thickened membrane proved to be a reliable method of treatment without the necessity of endoscopic third ventriculostomy or catheter placement.

High Flow Nasal Cannula Assisted Tracheostomy for Securing Airways in Patients with Acute Respiratory Distress Induced by Glottic Cancer (급성 호흡곤란이 발생한 성문암 환자에서 기도 확보를 위한 고유량 비강 캐뉼라 보조 기관절개술)

  • Hong, Seung Woo;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.31-34
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    • 2020
  • Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.