• Title/Summary/Keyword: Serious patient

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Syncope and Unconsciousness after Intravenous Injection of Antibiotics in Patient with Cerebrovascular Accident : Report of a Case (뇌졸중 환자에서 항생제 정주 후 유발된 실신과 의식소실: 증례보고)

  • Yoo, Jae-Ha;Son, Jeong-Seog;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.4
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    • pp.215-221
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    • 2012
  • The loss of consciousness in the dental office have many causes, such as, vasodepressor syncope, drug administration, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, acute allergic reaction, acute myocardial infarction, cerebrovascular accident, hyperglycemic reaction and hyperventilation. Patients have fainted during all phases of dental care: during tooth extraction and other surgical procedures, during local anesthetic injections, or during procedures such as venipuncture, on being seated in the dental chair, and even on first entering the dental office. If an elderly patient with known cardiovascular or cerebrovascular problems experiences a syncopal episode, differentiation from cerebrovascular insufficiency of more serious etiology, such as cerebrovascular accident, must be considered. And anaphylactic shock is also suggested during intravenous drug administration. This is a case report of syncope care during venous injection of cephalosporin in patient with cerebrovascular accident.

Iatrogenic Esophageal Perforation: An Occurrence from Feeding Tube Placement in a Premature Infant with a Pneumothorax

  • Jang, Yeong-Uk;Jang, Woo-Jung;Cho, Hye-Jung;Choi, Duk-Young;Shim, So-Yeon;Son, Dong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.387-390
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    • 2011
  • Spontaneous neonatal esophageal perforation (EP) is a rare condition. However, iatrogenic EP due to a feeding tube is not uncommon, particularly in premature infants. Iatrogenic EP can result in serious complications, such as a pneumothorax, and can be fatal. Usually a pneumothorax develops as a result of EP. However, we experienced an EP in a patient with a pneumothorax. The EP occurred after inserting a feeding tube while the patient was suffering from a pneumothorax. Thus care is needed when inserting the feeding tube in a patient with a pneumothorax.

Free Tissue Transfer in the Treatment of Infected Diabetic Foot Ulcers (유리 조직 이식술을 이용한 당뇨병성 족부 궤양의 치료)

  • Song, June-Young;Kim, Ki-Soo;Kim, Hee-Dong;Park, In-Suk
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.154-162
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    • 2001
  • Diabetic foot ulcer is a serious complication which result from long-standing diabetes. Especially, severe infected diabetic foot ulcer results in unwanted lower extremity amputation. The diabetic patient is considered the relative contraindication for microsurgery because of the severe peripheral vascular disease. Recently, microvascular free tissue transfer technique applied to diabetic foot ulcer. It is well known that free tissue transfer provides immediate soft tissue coverage and control of infection. So it is possible that preservation of the lower extremity through free tissue transfer. A retrospective study of diabetic patients who had infected foot ulcer from 1999 to 2000 with foot defects reconstructed with free tissue transfer were reviewed. Thirteen patients were studied with mean follow-up of 12.7 months. There were two deaths during follow-up period. There were two failures after free flap surgery. All eleven survived patients were ambulatory. There was no recurrence of ulcer. No patient need amputation above the ankle joint. We have found that free tissue transfer for infected diabetic foot ulcer is very effective surgical technique. Careful patient selection and regular follow-up is important.

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Experience of Modified Konno Operation in Patient with LVOTO (변형 Konno 술식을 이용한 죄심실 유출로 협착의 수술치험 - 3례 보고 -)

  • Park, Seung-Il;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.192-200
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    • 1990
  • The results of conventional operative resection of diffuse subaortic stenosis[tunnel subaortic stenosis] have been less than satisfactory. We have performed modified Konno operation to enlarge the outflow tract of both ventricle with a patch in three patients with diffuse tunnel subaortic stenosis in the department of Thoracic and Cardiovascular Surgery, Seoul National University Children`s Hospital. Preoperative left ventricular aortic pressure gradients were 135 mmHg, 50 mmHg, 80 mmHg respectively in these patients. After right ventriculotomy, the septotomy was done and extended beyond the limit of the stenosis and fibrous and/or muscular tissue was removed from each edge of septal incision. After adequate widening of the tunnel subaortic stenosis with various patches, right ventricle was closed primarily or with prosthetic patches successfully. One patient who was diagnosed as complete atrioventricular septal defect had complete AV block preoperatively and was implanted permanent pacemaker, and others who were sinus rhythm preoperatively have no serious postoperative rhythm disturbance. One patient developed mild postoperative aortic insufficiency and one who had preoperative aortic insufficiency has still same grade of aortic insufficiency after operation. All had good postoperative hemodynamics without any postoperative residual pressure gradient.

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A Study on the Job Satisfaction and Turnover Intention of Physical Therapist (물리치료사의 직무만족과 이직의도에 관한 연구)

  • Kim, Myung-Hoon
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.833-840
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    • 2001
  • This study was attempted to examine the relationship between job satisfaction and turnover intention of physical therapist in order to suggest some method to enhance their job performance and the degrees of job satisfaction. High turnover intention of physical therapist is one of the serious problems at the present time which providing low quality physical therapy. The data were collected from July 1, to August 31, 2000 and analyzed by ANOVA, Pearson Correlation Coefficients. The summarized result are as follows: 1. The job satisfaction score of physical therapists showed the highest of the pride of patient treatment and total mean score was 2.96. 2. Those who were in the range of 26 to 30 years of age showed the strongest desire to leave the hospital 3. There were 68.8% in male. 47.6% in female who hoped to turnover intention. 4. There were significant difference between those who want to leave and those who want remain in relation patient number, work hospital work years. 5. There were no significant difference between those who want to turnover intention and those who want remain in relation patient number and work years. 6. The major reason for job satisfaction were work time and work areas.

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Hypoplastic Left Heart Syndrome - Experience in one Patient - (좌심저형성 증후군 경험 1)

  • 장봉현
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.404-410
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    • 1987
  • An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

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The Necessity of Skilled Nursing Facilities for Stroke patients (뇌졸중 환자를 위한 전문요양시설의 필요성)

  • Kim Byung-Jo;Koo Bong-Oh;Kim Chung-Sun;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.14 no.4
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    • pp.75-86
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    • 2002
  • The patients with a central nervous impediment and a sequela caused by a Stroke are continuously increasing, and the burden of family and society for Stroke patients are also increasing. Since Stroke patients are required to receive a long time medical treatment and care. It adds a economical burden as well as a mental and physical burden of patient's family. In addition, it is a primary factor which deepens the disparity of medical resources in social aspect. But the social concern for these patients are very insufficient and are entirely left to the patient's family The mediation of Skilled Nursing Facility for Stroke patients enable to receive more special and proper medical treatment and recuperation service in the middle of time when they return to home from hospital. It also contributes to the settlement of the charge of patient's family and the serious disparity of medical resources. Therefore, this study will summon the social understanding of the necessity of Skilled Nursing Facilities through the above debate.

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A Clinical Report of a postpartum depression patient who treated by Giungoroen-therapy and IiGyeungByunQi-therapy (지언고론요법 및 이정변기요법으로 호전된 산후 우울증 환자 치험 1례)

  • Seo, Young-Min;Seo, Deok-Won;Ryu, Ho-Sun;Ahn, Hyo-Jin;Park, Se-Jin;Lee, Pil-Jae
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.3
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    • pp.151-161
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    • 2010
  • Objectives : Postpartum depression is a kind of serious problem which influences on the parturients, her family. In this case we tried psychotherapy to postpartum depression patient. Methods : We treated the patient with Oriental psychotherapy. And then we compared postpartum depression before treatment with on after treatment by Korean version of Edinburgh Postnatal Depression Scale(K-EPDS). Results : After treatments, the clinical symptoms were improved and K-EPDS was reduced 16 to 6. Conclusions : Oriental psychotherapy is effective on postpartum depression.

Pharyngocutaneous Fistula which Occurred During Postoperative Radiotherapy in Larynx Cancer Patient with Dementia (치매가 있는 후두암 환자에서 술 후 방사선치료 중 발생한 인두피부누공)

  • Kim, Jung Jun;Kang, Ju Yong;Choi, Ik Joon;Lee, Myung-Chul
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.51-55
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    • 2019
  • Pharyngocutaneous fistula is a relatively common, but serious complication after pharyngeal or laryngeal cancer surgery. It can cause wound infection, longer hospitalization period and sometimes carotid artery rupture which can be fatal. Recently, we experienced a 63-year-old larynx cancer patient who had dementia and alcoholic liver cirrhosis for underlying diseases. He underwent total laryngectomy and both neck dissection, and pharyngocutaneous fistula occurred during postoperative radiotherapy. Pharyngocutaneous fistula during postoperative radiotherapy has not yet reported in the literature, and there are few reports about pre and postoperative management of dementia patient after head and neck cancer surgery. Therefore, we report this case with a brief review of literature.

Cauda Equina Syndrome and Common Peroneal Nerve Palsy after Spinal Anesthesia -A case report- (척추마취후 발생한 마미증후군과 총비골신경마비 -증례 보고-)

  • Yoon, Kyung-Bong;Lee, Young-Bok;Kim, Soon-Yul;Lee, Jung-Won
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.390-393
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    • 1995
  • Although spinal anesthesia has long been considered a safe technique, it is not without risk or side effect. Cauda equina syndrome is a rare but serious complication of spinal anesthesia. We have experience a case of cauda equina syndrome after spinal anesthesia. A twenty year old healthy male patient complained of pain, numbness, tingling sensation and motor weakness on his right lower extremity 8 hours after subarachnoid blockade. On the following day, the patient was noted to have a right L1 to S2 radiculopathy. Magnetic Resonance Imaging results were unremarkable. The patient sprained his ankle while trying to move down from the bed, so short leg splint was applied. Then he had additional right common peroneal nerve injury from the splint. His neurologic symptoms improved gradually thereafter, and three months postoperatively his electromyogram revealed improving stage from right common peroneal nerve palsy.

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