• Title/Summary/Keyword: Patient acuity

Search Result 90, Processing Time 0.028 seconds

Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration (중기 나이관련황반변성 환자에서 항산화영양제 복용 후 장기 관찰 결과)

  • Bang, Seul Ki;Kim, Eung Suk;Kim, Jong Woo;Shin, Jae Pil;Lee, Ji Eun;Yu, Hyeong Gon;Huh, Kuhl;Yu, Seung-Young
    • Journal of The Korean Ophthalmological Society
    • /
    • v.59 no.12
    • /
    • pp.1152-1159
    • /
    • 2018
  • Purpose: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). Methods: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. Results: The mean patient age was $72.46{\pm}7.16years$. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was $0.13{\pm}0.14logMAR$ and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. Conclusions: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.

Orbital Cavernous Lymphangioma with Intracranial Extension - Case Report - (두개강내로 침윤을 보인 안와 해면상 림프관종 - 증 례 보 고 -)

  • Kim, Gi Hyune;Lee, Sung Lak;Cho, Jae Hoon;Kang, Dong Gee;Kim, Sang Chul
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.1
    • /
    • pp.105-109
    • /
    • 2001
  • Lymphangioma is a rare benign developmental vascular tumor that may be found in orbit, skull and elsewhere in head and neck. Few cases of extension of this benign but insidious tumor posteriorly out of the bony orbital cavity have been reported. The patient was 40-year-old man complaining of proptosis of right eye for one month. Physical examination revealed severe right exophthalmus, impairment of eyeball movement in all directions. Visual acuity was much impaired and he could percept only light with right eye. CT and MRI scans showed intraconal and extraconal involvement of ill-defined, heterogenous mass with extension of the tumor posteriorly beyond the orbital cavity involving right frontal and temporal lobe, skull and subcutaneous tissue. The tumor was subtotally removed via orbito-frontal approach without damaging vital neural and orbital component. Then, orbital roof reconstruction and cranioplasty were done with resin. Successful surgical removal of lymphangioma is very difficult due to its severe infiltration to surrounding tissue and tendency to bleed during debulking. We report a rare case of orbital cavernous lymphangioma with intracranial extension treated with surgical decompression, with review of literatures.

  • PDF

Fatal Case of Cerebral Aspergillosis : A Case Report and Literature Review

  • Lee, Jae-Chang;Lim, Dong-Jun;Ha, Sung-Kon;Kim, Sang-Dae;Kim, Se-Hoon
    • Journal of Korean Neurosurgical Society
    • /
    • v.52 no.4
    • /
    • pp.420-422
    • /
    • 2012
  • Cerebral aspergillosis is rare and usually misdiagnosed because its presentation is similar to that of a tumor. The correct diagnosis is usually made intra-operatively. Cerebral abscess with fungal infection is extremely rare and few cases have been reported, but it carries a poor prognosis. A 73 year-old man presented with decreased visual acuity and paresis of the right cranial nerve III. Magnetic resonance imaging (MRI) revealed a mass in the right cavernous sinus, extened to the anterior crainial fossa and the superior orbital fissure. During surgery, a well encapsulated pus pocket was found, and histopathological examination of the mass resulted in the diagnosis of aspergillosis. Despite appropriate anti-fungal treatment, the patient eventually died from fatal cerebral ischemic change and severe brain swelling. The correct diagnosis of cerebral aspergillosis can only be achieved by histopathological examination because clinical and radiological findings including MRI are not specific. Surgical intervention and antifungal therapy should be considered the optimal treatment. Early diagnosis and aggressive antifungal treatment provide good results.

The Study on the Deficiency Color of the Elementary School (초등학교 아동들의 색각이상에 대한 고찰)

  • Lee, Hak Jun;Kim, Chang Sik;Kim, Hong Gyun
    • Journal of Korean Ophthalmic Optics Society
    • /
    • v.4 no.1
    • /
    • pp.69-72
    • /
    • 1999
  • Testing of color vision by Ishihara's test was followed in 1306 healthy elementary school students from 8 to 13 years old. The number of color deficiency was 27(2.07%) patients who consisted in 25(3.8%) boys among 654(male) and 2(0.31%) girls among 652(female). The male' s patients were definitely more than female's. The type of color deficiency were consisted in 10(37%) patients of red-green anomaly, 7(26%) patients of anomalous trichromatism, 6(22%) patient of red-green anopia and 4(15%) patients who were difficult to classify. All of patients were normal binocular vision and visual acuity.

  • PDF

Carotid Cavernous Sinus Fistula with Abducens Nerve Palsy after Le Fort I Osteotomy : A Case Report (상악골절단술 후 외전신경마비를 동반한 경동맥 해면정맥동루)

  • Lee, Won-Hak;Kim, Dong-Ryul;Hong, Kwang-Jin;Lee, Jeong-Gu
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.22 no.2
    • /
    • pp.243-248
    • /
    • 2000
  • Carotid cavernous sinus fistula(CCSF) is an abnormal communication at the base of the skull between the internal carotid artery and the cavernous sinus. Fistula is almost associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of fractures through the base of the skull, which cause the laceration of the internal carotid artery near the cavernous sinus. The signs and symptoms of CCSF are pulsating exophthalmosis, orbital headache, pain, orbital or frontal bruit, loss of visual acuity, diplopia and ophthalmoplegia. Angiography reveals a definite CCSF and a detachable balloon embolization is known to be the treatment of choice. Even though carotid cavernous sinus fistula is an uncommon complication after orthognathic surgery, several cases of CCSF due to congenital anomalies, pre-existing aneurysms and abnormally thickened maxillary posterior wall have been reported in the literature. We have experienced a case of CCSF after Le Fort I osteotomy for maxillary advancement in skeletal class III patient and the cause, pathogenesis, diagnosis and treatment of this case.

  • PDF

Clinical Features of Ocular Toxoplasmosis in Korean Patients

  • Park, Young-Hoon;Han, Jae-Hyung;Nam, Ho-Woo
    • Parasites, Hosts and Diseases
    • /
    • v.49 no.2
    • /
    • pp.167-171
    • /
    • 2011
  • We report here the records of 10 consecutive Korean patients (10 eyes) with ocular toxoplasmosis which showed the typical clinical manifestations with seropositivity for Toxoplasma gondii specific IgG antibodies by micro-ELISA between 2006 and 2010. Nine patients were males and 1 was female; their age was $50.5{\pm}13.8$ years. The most common accompanying signs were vitritis (100%), anterior uveitis (70%), and scattered white deposit (80%). Pre-existing retinochoroidal scar was found in 1 (10%) patient. All patients received antiparasitic chemotherapy and systemic corticosteroid treatment, which resolved the presenting attack and recovered the visual acuity better than initial one in 9 patients and worse in 1. Optic atrophy, cataract, and retinal neovascularization were observed during the follow-up period and recurrence was detected in 3 eyes (30%) 6 to 20 months after the initial attack. In Korea, although rarely detected and reported, ocular toxoplasmosis needs more attention in clinical field of retinal diseases.

A Case of Valsalva Retinopathy Associated with Straining at Stool

  • Lee, Tae-Yoon;Chang, Woo-Hyok
    • Journal of Yeungnam Medical Science
    • /
    • v.23 no.2
    • /
    • pp.227-231
    • /
    • 2006
  • The Valsalva maneuver is described as an expiratory effort against a closed glottis or airway. It leads to elevation of retinal venous pressure and may result in retinal hemorrhage. A fifty two- year-old man presented with an acute reduction of central visual acuity in his right eye which occurred after considerable straining at stool. Detailed past medical history revealed that he suffered from chronic constipation and hypertension. There were one disc sized subhyaloid hemorrhage and three small intraretinal hemorrhages around the fovea at the dilated fundus examination. After three months of follow-up without any treatment, the retinal hemorrhages resolved without any sequelae. Here we report a patient with sudden visual loss and retinal hemorrhage.

  • PDF

A Study on the Application of Physical Restraints in Intensive Care Units (일 대학병원 중환자실의 억제대 사용실태)

  • Kim, Mi-Yeon;Park, Jeong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.17 no.2
    • /
    • pp.177-186
    • /
    • 2010
  • Purpose: The purpose of this descriptive study was to investigate the application of physical restraints in ICUs of a university hospital. Method: Data were collected from August 1 to October 1 2009, using a recording tool from Electric Nursing Records and an observation tool for physical restraints and related factors. Frequency, percentage, and paired t-test with the SPSS/WIN 16.0 program were used to analyze the data. Results: The application rate for physical restraints in 5 ICUs was 34.3%, the highest application rate was 48.4% in the neurosurgical ICU. The mean frequency for physical restraint application per patient was 1.14, and the mean hours of restraint application per incident was 113.01 hours. The most common complications of physical restraints were bruising and edema. Conclusion: Many ICU nurses use physical restraints when caring for patients who are at high risk for falls, including patients have high levels of acuity, decreased level of consciousness or increased irritability. When physical restraints are applied, patients show resistance against the use resulting in side effects of bruising and edema. Therefore, nurses should observe changes in restrain sites, perform nursing interventions to prevent complications, and minimize the use of physical restraints.

Ocular chemical burns following accidental instillation of tinea pedis treatment solution: A report of two cases (족부백선 치료액 오인 점안 후 발생한 안구화학손상 2례)

  • Kim, Jung Ho;Chung, Han Sol
    • Journal of The Korean Society of Clinical Toxicology
    • /
    • v.20 no.1
    • /
    • pp.35-38
    • /
    • 2022
  • Many commonly used household chemicals and medical eye drops look alike, resulting in a worldwide increase in incidences of accidents caused by confusion between similar-looking agents. In this case report, we present two patients who visited the emergency department following inadvertent instillation of tinea pedis treatment solution instead of eye drops. Both patients developed corneal chemical burns following the accidental application. Notably, the visual acuity and symptoms eventually recovered for both patients after hospitalization. However, complete recovery occurred only after several weeks. Both patients were relatively old and had been prescribed eye drops after previous ophthalmic surgery. Since the eye is a sensory organ that receives visual information, ocular injuries significantly affect the quality of life and social functioning of the patient. Incidences of accidental misidentification of eye drops are steadily increasing in South Korea; unfortunately, regulatory policies are unavailable to avoid such hazards. Therefore, physicians should be mindful of the potential risks associated with misidentification of everyday household products and must spend time educating patients when prescribing eye drops. Policy regulations are warranted for products with containers that resemble eye drop bottles. Such items need to be clearly labeled with additional warnings to prevent misidentification and accidental ocular instillation.

Patient characteristics associated with length of stay in emergency departments (응급실 재원시간과 관련된 환자의 특성)

  • Chung, Seol-Hee;Hwang, Jee-In
    • Health Policy and Management
    • /
    • v.19 no.3
    • /
    • pp.27-44
    • /
    • 2009
  • The length of stay in emergency departments has been used as a quality indicator to reflect the overall efficiency of emergency care. Identifying characteristics associated with length of stay is critical to monitor overcrowding and improve efficient throughput function of emergency departments. This study examined the level of waiting time for initial assessment by physician and length of stay in emergency departments. Furthermore, we investigated the characteristics of patients' attendance associated with length of stay. An observational study was performed for a sample of 1,526 patients visiting ten nation-wide emergency departments. A structured form was designed to collect information about patients' demographics, route of admission, time and mode of arrival, triage level, cause of attendance, initial assessment time by physician, departure time, and disposition. Multiple regression analysis was performed to determine factors associated with length of stay. The average length of stay was 209.4 minutes (95% confidence interval [CI]=197.1-221.7), with a mean waiting time for initial assessment of 5.9 minutes (95% CI=5.1-6.7). After controlling for emergency department characteristics, increasing age, longer waiting times, attendance due to diseases, higher acuity, multiple diagnoses($\geq$2) and requiring admission or transfer to other health care facilities were positively associated with length of stay in emergency departments. The findings suggest that both patients' characteristics and the flow between emergency departments and parent hospitals should be taken into account in predicting length of stay in emergency departments.