• Title/Summary/Keyword: Serious patient

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Right Pneumonectomy in a Patient with Poor Pulmonary Function (폐 기능이 불량한 환자에서의 우측 전폐절제수술)

  • 주석중
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1218-1220
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    • 1992
  • Pneumonectomy on a patient with documented poor pulmonary function indicating a contraindication to surgery can be associated with a high risk of serious postoperative morbidity or mortality. However the usual criterias, on the performance of a pneumonectomy on a high risk patient based on the preoperative assessment of the pulmonary function may not sometimes predict with accuracy the operative outcome in the postoperative period. We recently performed pneumonectomy with good results on a patient with poor pulmonary function that would otherwise have been an absolute contraindication to surgery by usual criteria.

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Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

Valproic Acid-Induced Hyperammonemic Encephalopathy as a Cause of Neurologic Deterioration after Unruptured Aneurysm Surgery

  • Lee, Sangkook;Cheong, Jinhwan;Kim, Choonghyun;Kim, Jae Min
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.159-162
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    • 2015
  • Neurological deficits after brain surgery are not uncommon, and correct and prompt differential diagnosis is essential to initiate appropriate treatment. We describe a patient suffering from loss of consciousness due to hyperammonemia, following valproic acid treatment after surgery for an unruptured cerebral aneurysm. A 57-year-old female patient underwent successful aneurysmal neck clipping to correct an unruptured aneurysm. Her postoperative course was good, and she received anti-epileptic therapy (valproic acid) and a soft diet. Within a few days the patient experienced mental deterioration. Her serum valproic acid reached toxic levels (149.40 mg/L), and serum ammonia was fifteen times the upper normal limit (553 mmol/L; normal range, 9-33 mmol/L). After discontinuation of valproic acid and with conservative treatment, the patient recovered without any complications. Valproate-induced hyperammonemic encephalopathy is an unusual but serious neurosurgical complication, and should not be disregarded as a possible cause of neurological deficits after neurovascular surgery. Early diagnosis is crucial, as discontinuation of valproic acid therapy can prevent serious complications, including death.

Determinants of selecting a doctor in specialized medical institutions and general hospitals (종합전문요양기관과 종합병원의 선택진료 결정요인)

  • An, Byeung-Ki;Park, Jae-Yong
    • Health Policy and Management
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    • v.21 no.4
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    • pp.599-616
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    • 2011
  • This research was performed to investigate the determination factors of medical service to cover the fee for selecting a doctor which is one of the most important causes of debilitating national health insurance in Korea. Data was from Korea Health Panel and analyzed by Dutton(1986)'s medical service model which was an extended Anderson Model and was widely used in the researches on determination factors of medical service. The results were as follows; In the determinants of selecting a doctor in specialized medical institutions and general hospitals, patients with serious diseases selected doctors more often than other patients. By industrial accident compensation insurance law and enforcement ordinances, insurance covers the fee of selecting a doctor in the hospitals appointed by Labor Welfare Corporation for the patients in critical conditions under industrial accident compensation insurance, while health insurance patients pay the fee themselves for selecting a doctor in all cases. It is suggested that patients with serious diseases proved by medical opinion be provided with health care insurance in selecting a doctor and that the health insurance benefit coverage be enhanced by staged lowering of patient's cost-sharing.

A Case of Serious Caustic Injury on Gastrointestinal Tract after Ingestion of Sodium Carbonate Peroxyhydrate (과탄산 나트륨 음독 후 발생한 심한 위장관 손상 1례)

  • Won Tae Young;Kim Seung Woo;Kang Bo Seung;Im Tai Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.141-146
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    • 2004
  • Laundery detergent ingestions are generally considered to have minor consequences. But some detergent ingestions have severe consequences. Unlike household bleaches contain sodium hypochlorite, bleaching agents that contain sodium carbonate have the potential to cause significant mucosal damage to the gastrointestinal tract if ingested. Especially, when ingested in solid form of Sodium carbonate, corrosive injury is much heavier. Therefore, patient who ingest sodium carbonate peroxyhydrate need more intensive management than patient who ingest other bleaches. We experienced a case of serious caustic injury after ingestion of Sodium Carbonate Peroxyhydrate. We report this case with review of literature.

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Antibiotic-Induced Increase in Inflammatory Markers in Cured Infectious Spondylitis : Two Case Reports

  • Eom, Ki Seong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.487-491
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    • 2019
  • Conservative therapy with appropriate antibiotics is essential for most patients with infectious spondylitis. Although most antibiotics do not cause problems if it used properly and serious side effects are rare, side effects can occur with any class of drugs and adverse reactions of antibiotics can range from mild allergic reactions to serious and fulminant adverse events. These side effects are also extremely variable from patient to patient and from antibiotic to antibiotic. A side effect of antibiotics may paradoxically increase inflammatory marker levels. Here, the author presents two cases of antibiotic-induced increase in inflammatory markers in cured infectious spondylitis. The patients were successfully treated after stopping the antibiotic therapy. The differential diagnosis between antibiotic side effects and infection should be considered very carefully because the treatment is completely different. Although the exact mechanisms underlying successful treatment without antibiotics are unclear, we should consider the side effects of antibiotics when following inflammatory markers during treatment of infectious spondylitis.

A Case Report of a Patient with Diabetic Foot Lesions (당뇨병성 족부병변 환자 치험 1례)

  • Kim, Byoung-Woo
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.684-689
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    • 2004
  • One of the serious long-tenn complications of diabetes mellitus is the diabetic foot lesion. Diabetic foot lesions are a major cause of morbidity, mortality, disability in patients with diabetes and frequent cause of lower-extremity amputations. The treatment of diabetic foot lesions is based on the strict control of diabetes mellitus. A patient with diabetic foot lesions was treated with Cheunhwasangamibang and improvement was seen. Results in this case support a role for Cheunhwasangamibang in controlling diabetes mellitus, and are here reported to encourage further study.

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An Aortic Root Abscess Presenting as a Suprasternal Pulsatile Mass

  • Raman, Karthik;Sheriff, Ejaz Ahmed;Jamesraj, Jacob;Kumar, Ram
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.178-181
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    • 2019
  • Prosthetic valve endocarditis with aortic root abscess is a serious condition requiring urgent surgical intervention. We present a case caused by an infected Bentall mechanical valve conduit after cardiac surgery in a patient who was referred for a suprasternal pulsatile mass. The patient also had 1 episode of sentinel haemorrhage.

Design of 1-DOF Walking Orthosis for Paralysis Patients (하지 마비 환자를 위한 1 자유도 보행 보조기 설계)

  • 정철희;최용제
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.1137-1142
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    • 2004
  • Walking training is one of the most important rehabilitation processes with paralysis patient. Walking training by using an orthosis can help advancing a patient's independent level. However, existing orthoses have some serious demerit of mechanical problem that the knee joint is locked in the state where it is completely extended, which increases energy consumption and fatigue. For this reason, it is suggested, for more practical orthosis, that the knee joint should be placed and it should have capability of suspending patient's weight. In this paper, 1-DOF walking orthosis which compensates the demerit of the existing orthosis and secures patient's mobility has been proposed. New orthosis has been designed under the following two premises. First, the knee joint of the orthosis was designed fold in order for the orthosis to move in a walking pattern similar to that of a normal person. Second, the knee joint was designed to extend during the swing phase and lock safely during the stance phase.

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