• Title/Summary/Keyword: Shock patient

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A Clinical Evaluation of 402 Chest Traumas (흉부손상 401례에 대한 임상적 관찰)

  • Ahn, Byoung-Hee;Lee, Ho-Wan;Lee, Dong-Joon
    • Journal of Chest Surgery
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    • v.14 no.4
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    • pp.311-318
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    • 1981
  • A clinical evaluation was performed on 402 cases of chest trauma those were admitted and treated at the department of chest surgery, Chonnam National University Hospital, during the past 13 years and 7 months from Jan. 1968 to July 1980. 1. The ratio of male to female was 5.5:1 in 1968 and 3.4:1 in 1980 with progressive increase of female patient and age from 20 to 59 years is 81.0%. 2. The most common cause of chest trauma was stab wound in penetrating trauma and traffic accidents in nonpenetrating trauma. 3. The most common injury from chest trauma was hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. 4. Hemothorax was observed in 76 cases [18.9%] of total cases and rib fracture was observed in 163 cases [40.5%] of total cases. 5. Rib fracture was prevalent from 4th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and with other organ injuries. 6. Open thoracotomy was performed in 72 cases [17.9%] and others were treated with conservative nonoperative treatment. 7. Overall mortality was 4.5% [19 cases], and common causes of the death were shock and respiratory insufficiency.

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Thoracic Trauma: Analysis of 150 Cases (흉부손상 150례에 대한 임상적 관찰)

  • 김형묵;김인수
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.113-124
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    • 1972
  • Clinical observations were performed on 150 cases of chest trauma, those were admitted and treated at the Department of Surgery, Korea University Woosok Hospital, during the past 8 years period from August 1965 to August 1972. 1. The ratio of male to female patient of chest trauma was 3.4:1 in male predominence and age from 20 to 50 occupied 62% of the total cases. 2. The most common cause of chest trauma was traffic accident in this series. Eighty-one cases[54%] were injured by traffic accident and total cases due to blunt trauma [non-penetrating injury] were 113 cases[75.4%]including the cases with traffic accident, and remaining 37 cases[24.6%] were due to penetrating injury including 25[16.6%] cases of stab wounds. 3. Hemopneumothorax were observed in 645/[96 cases] of the total cases, and etiologic distribution revealed 78.1% due to non-penetrating trauma and 20.8% due to penetrating injury. 4. Rib fracture was found in 50% of cases. Common injuries associated with rib fracture were lung, brain and liver. 5. Most common symptom was chest pain and respiratory difficulty, and common sign associated with chest injury was decreased respiratory sound and subcutaneous emphysema. 6. Conservative non-operative treatment was performed in 94 cases[62.6%] and 56 cases [37.4%] were treated with operative treatment including 31 cases[20.6%] with open thoracotomy. 7. Overall mortality was 9.3%[14 cases] and most common causes of death were due to brain edema,asphyxia and shock.

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Tracheoplasty with using the Costal Cartilage, Including the Perichondrium, for Treating a Tracheoinnominate Artery Fistula - Surgical experience of one case - (기관절개술 후 발생한 기관무명동맥루에서 연골막를 포함한 늑연골을 이용한 기관성형술 - 수술치험 1예 -)

  • Cho, Seong-Ho;Kae, Yoe-Kon;Kim, Jong-In;Cho, Sung-Rae
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.651-654
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    • 2007
  • Tracheoinnominate artery fistula (TIF) is a very rare complication that can happen after long standing tracheostomy or insertion of an endotracheal tube and its mortality is very high. This condition requires early diagnosis and urgent management because of the life threatening results from tracheal obstruction or hypovolemic shock that is caused by massive bleeding. We report here on a case of successful tracheoplasty with using the costal cartilage, including the perichondrium, in a patient with laryngeal stricture, and this was done to preserve the trachea for the following operation to relieve the laryngeal stricture.

Peripheral gangrene in patients with severe falciparum malaria: report of 3 cases

  • Thanachartwet, Vipa;Krudsood, Srivicha;Wilairatana, Polrat;Phumratanaprapin, Weerapong;Silachamroon, Udomsak;Looareesuwan, Sornchai
    • Parasites, Hosts and Diseases
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    • v.44 no.2 s.138
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    • pp.139-143
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    • 2006
  • Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patients with falciparum malaria. Patients with this complication have generally undergone early amputation of the affected areas. In this report, we describe 3 adult Thai patients presented at the Hospital for Tropical Diseases, Bangkok, with high grade of fever ranged 6-9 days, jaundice, acute renal failure, respiratory failure, alteration of consciousness and shock. Two patients had gangrene developed at the lower extremities on day 1 of hospitalization and 1 patient had gangrene developed on day 3. Blood smears revealed hyperparasitemia with Plasmodium falciparum. These patients were diagnosed as having severe malaria with peripheral gangrene. The resolution of gangrene was successfully achieved by treatment with artesunate and conservative treatment in 2 of 3 cases.

Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman

  • Park, Seong Hoon;Kim, Joo Hyun;Suh, In Suck;Kim, Kwang Yong;Jeong, Hii Sun
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.18-22
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    • 2017
  • Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

Acquired Tracheal Dilatation (후천성 기관확장증)

  • Choi, Jong-Ouck;Kim, Yong-Hoan;Kim, Hye-Jeong;Lee, Seung-Hoon;Choi, Geon
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.185-187
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    • 1997
  • Acquired tracheal dilatation is a state of abnormal tracheal dilatation developing from various causes. Tracheomalacia and tracheal dilatation can develop in respiratory distress patients with prolonged endotracheal intubation with assisted positive-pressure ventilation due to positive airway pressure and high cuff pressure. The authors have recently experienced one case of respiratory failure, cardiac arrest, and whole body emphysema after tracheostomy and portex tube insertion were performed to patient with the endotracheal intubation with assisted positive-pressure ventilation for two weeks in the septic shock resulted from colon perforation, who developed tracheal dilatation. We summarize diagnostic and therapeutic strategies of acquired tracheal dilatation for the prevention of emergency status and the management for that patients.

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Utility of Magnetic Resonance Imaging in the Diagnosis of Lung Adenocarcinoma with Extensive Necrosis: a Case Report

  • Choi, Sang Lim;Cha, Min Jae;Choi, Hye Won;Park, Byung-Joon;Kim, Mi Kyung;Kim, Jae Yeol
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.4
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    • pp.254-259
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    • 2018
  • Application of magnetic resonance imaging (MRI) for assessment of pulmonary disease has been limited, due to susceptibility to cardiac pulsation, respiratory motion, and inhomogeneity of the magnetic field of the lung. With technical advances of MRI and unmet clinical needs for more accurate diagnosis and assessment of the disease, however, the use of MRI for evaluation of the lung has broadened. Herein, we present a case of pneumonic-type lung adenocarcinoma in a patient with history of anaphylactic shock to iodinated contrast medium, in which MRI played a critical role for targeted lung biopsy and cancer staging. Through this paper, we would like to report potential value of MRI in assessment of lung cancer.

Trigeminal neuralgia management after microvascular decompression surgery: two case reports

  • Hwang, Victor;Gomez-Marroquin, Erick;Enciso, Reyes;Padilla, Mariela
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.403-408
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    • 2020
  • Trigeminal neuralgia (TN) involves chronic neuropathic pain, characterized by attacks of repeating short episodes of unilateral shock-like pain, which are abrupt in onset and termination. Anticonvulsants, such as carbamazepine, are the gold standard first-line drugs for pharmacological treatment. Microvascular decompression (MVD) surgery is often the course of action if pharmacological management with anticonvulsants is unsuccessful. MVD surgery is an effective therapy in approximately 83% of cases. However, persistent neuropathic pain after MVD surgery may require reintroduction of pharmacotherapy. This case report presents two patients with persistent pain after MVD requiring reintroduction of pharmacological therapy. Although MVD is successful for patients with failed pharmacological management, it is an invasive procedure and requires hospitalization of the patient. About one-third of patients suffer from recurrent TN after MVD. Often, alternative treatment protocols, including the reintroduction of medications, may be necessary to achieve improvement. This case report presents two cases of post-MVD recurrent pain. Further research is lacking on the success rates of subsequent medication therapy after MVD has proven less effective in managing TN.

Successful Endoscopic Treatment of Hepatic Duct Confluence Injury after Blunt Abdominal Trauma: Case Report

  • Park, Chan Ik;Park, Sung Jin;Lee, Sang Bong;Yeo, Kwang Hee;Choi, Seon Uoo;Kim, Seon Hee;Kim, Jae Hun;Baek, Dong Hoon
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.93-97
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    • 2016
  • Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

A Study on the Quality of Life, Family Support and Hope of Hospitalized and Home Care Cancer Patients (입원한 암환자와 재가 암환자의 가족지지, 희망, 삶의질 정도에 관한 연구)

  • 조계화;김명자
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.353-363
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    • 1997
  • With the occurrence of cancer, most cancer patients experience various emotional changes such as anxiety, depression, and emotional shock. Especially in our country, cancer has been recognized as an incurable disease resulting in death. The number of cancer patients increases daily. But as the survival rate of cancer patients is also increasing, there is a need to find the better methods of nursing care for cancer patients. The purposes of this paper are as follows : 1) To understand family support and hope and quality of life for the cancer patient both during hospitalization and at home. 2) To determine the relationship between family support, hope and quality of life. To examine the problems. we used a questionnaire and obtained data form the records of 45 home care and 90 hospitalized (in 3 university hospitals) patients in Taegu area from the period of June 15 to August 15, 1996. SPSS /PC was used for the data analysis and the statistical methods used were the T-test and ANOVA. The results of this paper are as follows : 1) In the aspect of family support, there is no difference between hospitalized and home care cancer patients(t=1.63, P>0.01). 2) In the aspect of hope, hospitalized cancer patients have a higher score than home care cancer patients(t=3.08, P>0.01). 3) In the aspect of quality of life, hospitalized cancer patients have a higher score than home care patients(t=2.96, P<.01). 4) There is a correlation between quality of life and hope with a correlation coefficient r=0.5195 and P=0.000. In addition, the correlation coefficient between quality of life and family support is 4179 with P=0.000. 5) The family support of the cancer patient is influenced by sex(F=9.1863, P<0.01), education(F=4.3641, P<0.01) and the level of life (F=5.5002, P<0.01), 6) The hope of cancer patients is influenced by the number of hospitalizations(F=3.6413, P<.05), education(F=6.0113, P<.01). and the level of life(F=5.0649, P<.01). 7) The quality of life of cancer patients is influenced by the number of hospitalization(F=5.1167, P<0.05), education(F=3.1590, P<0.01) and the level of life(F=5.6942, P<0.01).

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