• 제목/요약/키워드: a serious case

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흉추 압박골절환자를 위한 경피적 척추성형술의 새로운 접근법 -증례 보고- (A New Method of Approach for Percutaneous Thoracic Vertebroplasty in Vertebral Compression Fracture -Case report-)

  • 신근만
    • The Korean Journal of Pain
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    • 제13권2호
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    • pp.237-241
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    • 2000
  • Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

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노인이 지각한 건강에 대한 주관성 연구 (A Study on Subjectivity and the Health of the Elderly)

  • 정혜경;김경희;권혜진;윤은자;정연강
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.32-43
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    • 1999
  • This study is to classify subjectification and the perceived health of the elderly according to Q-methodology and to provide basic materials for health promotion of the elderly. In this study, 28 elderly people residing in Seoul classified 33 selected statements in to 9 standards. The material taken from this process resulted in 4 types by the analysis using a PC QUANL program. Case 1 thought that religion was important for their health. Case 2 were go-getters they thought they felt healthy at work. Case 3 took a serious view of their relationships with other people. Case 4 centered around the couple, and thought it important to live with their life's companion.

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자리공 뿌리 섭취로 발생한 급성 중독 1례 : 증례보고 (Phytolacca Radix Poisoning: A Case Report)

  • 전천후;조충식
    • 대한한방내과학회지
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    • 제41권2호
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    • pp.241-247
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    • 2020
  • Objectives: This study aims to present the case of poisoning associated with Phytolacca radix. Case Presentation: A 61-year-old male with nausea, vomiting, dizziness, and abdominal pain after ingesting about 10 centimeters of Phytolacca radix visited Korean medicine hospital. He began to show symptoms one hour after eating the plants. Methods: The patient was diagnosed with poisoning by Phytolacca radix. The patient received acupuncture, moxibustion, and herbal medicine treatment including Glycyrrhizae radix. laboratory test including complete blood count, biochemistry was also conducted. Results: Treatment, including acupuncture, moxibustion, and herbal medicine, improved his symptoms. His symptoms subsided within two hours. The laboratory test conducted on the next day show a slight increase in his white blood cell, blood urea nitrogen, urine ketone levels. There was no damage to the liver or kidneys. Conclusions: This report demonstrates the need for caution when consuming wild plants, which could lead to serious adverse effects. Patients should be alerted to the indiscriminate ingestion of wild plants. Further research on how to treat poisoning in Korean medicine needs to be considered to confirm these findings.

사상의학(四象醫學)과 난치성질환(難治性疾患) (Sasang Constitutional Medicine and Incurable Disease)

  • 박계수;송일병
    • 사상체질의학회지
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    • 제14권3호
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    • pp.1-6
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    • 2002
  • 1.Objects of Research This research is purposed to find methods of treatment on serious diseases, through summarizing etiology, classification and treatment on serious diseases proposed in Sasang constitutional medicine 2.Methods of Research It was researched as bibliologically with Dong-mu's chief medical writings such as ${\ulcorner}$Dongyi Soose Bowon(東醫壽世保元)${\lrcorner}$, ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun(東醫壽世保元四象草本卷)${\lrcorner}$ 3.Results and Conclusions 1. The principle of treatment in the previous medicine is to treat each disease by 'Assisting-Good Qi' and 'Removig-Bad Qi'. but The principle of treatment in Sasang Constitutional medicine is to manage incurable disease by helping 'Essential Qi of each constitution(體質正氣)' 2. Incurable disease is classified into a chronic disease by 'Nature(性氣)' and a acute disease by 'Emotion(情慾)'. Both diseases became serious through 'Noi-Ok(牢獄)' and 'Wi-Gyoung(危傾)'. A chronic disease is much in the middle years of life and become senile disease. A acute disease is much in the young years of life and make patients die young. 3. prognoses of incurable disease are different from degree of Inherent vitality(命脈實數) and term of disease. The case in which Inherent vitality is exhausted is thought that is unable to treat. 4. The prevention of incurable disease Is more important the treatment of one in Sasang Constitutional Medicine. but if incurable disease is caught, Medicine(醫藥) and management(調養) must be used together for treatment of incurable disease. Medicine is more important in the level of 'Noi-Ok(牢獄)' and management is more important in the level of 'Wi-Gyoung(危傾)'. 5. Therefore, incurable disease should be treated by method that 'Essential Qi of each constitution(體質正氣)' is recovered and declination is removed through 'controlling mind(治心) and correcting Qi(正氣), so then the state of 'Golden mean(中庸)' is reached.

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Effects of a Case-Based Sepsis Education Program for General Ward Nurses on Knowledge, Accuracy of Sepsis Assessment, and Self-efficacy

  • Kim, Bohyun;Jeong, Younhee
    • Journal of Korean Biological Nursing Science
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    • 제22권4호
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    • pp.260-270
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    • 2020
  • Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

뇌성마비로 인한 양측성 첨내반족 변형의 수술적 치료 후 발생한 종외반족 변형의 치료(1예 보고) (Treatment of Calcaneovalgus Deformity Following Operative Treatment of Diplegic Equinovarus Deformity in Cerebral Palsy Patient (A Case Report))

  • 김유미;이우천;정웅서
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.197-202
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    • 2009
  • Calcaneal or calcaneovalgus deformity can occur after surgical treatment of equinus or eguinovarus deformity in cerebral palsy patient. It is a serious complication and the results of many conservative and operative treatments are reported unsatisfactory. We experienced one case of both calcaneovalgus deformity following operative treatment of diplegic equinovarus deformity in a spastic cerebral palsy patient and report about the result of the treatment.

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동종 건을 이용한 아킬레스건의 광범위 결손의 치료: 증례 보고 (Treatment of Massive Defect in Achilles Tendon with Tendon Allograft: A Case Report)

  • 이정우;김명진;안재훈;변주환
    • 대한족부족관절학회지
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    • 제19권3호
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    • pp.114-117
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    • 2015
  • Deep infection of Achilles tendon is one of the serious complications that occur after open repair of the tendon. It sometimes leads to a very large tendon defect during the course of treatment. We report on a case of massive defect in Achilles tendon, which was successfully treated with Achilles tendon allograft and flexor hallucis longus tendon transfer.

A Case of Myelopathy after Intrathecal Injection of Fluorescein

  • Park, Kwang-Yeol;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • 제42권6호
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    • pp.492-494
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    • 2007
  • We present a case with seizure, confusion, hypesthesia and paraplegia after intrathecal injection of fluorescein. A 41-year-old man was admitted to our institution for the management of the CSF leakage. Intrathecal injection of fluorescein was performed and he complained of severe pain and numbness in the lower extremities at the end of the injection. Four hours later, he exhibited confusion, paraparesis and two episodes of generalized seizures. Two days later, he showed paraplegia and all sensory modalities below the T12 level were absent. Spine magnetic resonance imaging revealed myelopathic change in the lower thoracic spinal cord. There was no improvement of weakness and sensory deficits in lower extremity even 14 days after fluorescein injection. We speculated that thoracic myelopathy was associated with the intrathecal injection of fluorescein. In spite of its rarity, the complication after intrathecal injection of fluorescein could be serious. Thus, obtaining an informed consent with discussion with patient before the procedure is mandatory.

Mandibular Reconstruction using Simulation Surgery with 3D RP Model in Osteoradionecrosis Patient: A Case Report

  • Park, Tae-Jun;Kim, Hong-Joon;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • 제2권2호
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    • pp.76-79
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    • 2015
  • One of the most serious complications after head and neck radiation is osteoradionecrosis (ORN) of the jaw. The etiology of ORN is extraction, minor dental procedure or dental implant surgery. When ORN of the jaw progressed to stage III, free fibular flap is the most useful methods for reconstruction. In this case report, a 67-year-old ORN patient who underwent fibular free flap reconstruction using simulation surgery with 3-dimensional rapid prototype (3D RP) model was reviewed. After partial mandibulectomy, a osteocutaneous fibula flap was used for reconstruction. Oro-cutaneous fistula was resolved after operation. Patients reported improved food intake after operation without pus discharge. Functional and esthetic results showed successful reconstruction.

Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

  • Jalali, Elnaz;Tadinada, Aditya
    • Imaging Science in Dentistry
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    • 제45권1호
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    • pp.67-72
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    • 2015
  • Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.