• Title/Summary/Keyword: treatment difficulty

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Surgical Treatment of Adenoid Cystic Carcinoma by Left Tracheal Sleeve Pneumonectomy (좌측 수상 전폐 적출술에 의한 선양 낭포암 치험 1례)

  • 김동원
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.413-417
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    • 1994
  • Adenoid cystic carcinoma usually grows in the trachea or near its bifurcation and causes obstruction of the air way. We recently experienced a 33 year-old male patient who had adenoid cystic carcinoma in the left main bronchus with the chief complaint of productive cough. On the bronchoscopy, the mass obstructed the left main bronchus completely and had nodularity and increased vascularity.The trachea was shifted to the left side and the lower lobe of the left lung was atelectatic on chest X-ray and computed axial tomogram.He underwent left tracheal sleeve pneumonectomy and lymph node dissection through bilateral thoracotomy. At first,we attempted left tracheal sleeve pneumonectomy through the left thoracotomy,however, it was very difficult to perform carinoplastic procedure after sleeve resection of 2.5cm of distal trachea and 1cm of proximal right main bronchus including whole left lung because of poor operative field and difficulty in the anastomosis of the right main bronchus to the distal end of the trachea without tension.Therefore after radical resection of the left lung we made right thoracotomy,through which we could anastomosed the distal trachea and right main bronchus with 4-0 PDS interrupted suture after mobilization of the right hilum without difficulty. The tumor was confirmed to be adenoid cystic carcinoma with metastasis to subcarinal lymph node histopathologically. Postoperative course was uneventful but he needed two bronchoscopic procedure to clear distal airway of the retained bronchial secretion. He was discharged at 14 days after operation with complete recovery.

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Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation

  • Lim, Seon Woo;So, Eunsun;Yun, Hye Joo;Karm, Myong-Hwan;Chang, Juhea;Lee, Hanbin;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.245-254
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    • 2018
  • Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

THE ORAL HEALTH STATUS OF DISABLED PEOPLE WITH CEREBRAL PALSY (뇌성마비 장애인의 구강보건 실태)

  • Sung, Min-Ji;Kim, Seon-Mi;Yang, Kyu-Ho;Choi, Nam-Ki
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.1
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    • pp.5-11
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    • 2009
  • The objective of this study was to assess oral health status such as prevalence of dental caries, gingivitis and other combined disorder, orofacial dysfunction in patients with cerebral palsy(CP), as well as the state of tooth brushing, possibility of dental treatment. Sixty-six subjects with CP aged 9 to 37 years were included in the study. Clinical caries status(DMFT index) and other data were evaluated and statistically analyzed using SPSS program (SPSS 17.0). The results were as follows: The DMFT index and prevalence of gingivitis of study subjects were 2.82(male), 3.33(female) and 89%, respectively. DMFT index classified into four groups according to age as follows: DMFT index were 1.14(ages 6-11), 1.40(ages 12-14), 2.16(ages 15-24), 4.15(ages 25-37). In addition to the physical disorder, speech difficulty(86%), epilepsy(35%) and visual impairment(14%) were associated and the epilepsy medication was the most common medication. And orofacial dysfunction such as the eating difficulties(79%), drooling(36%), swallowing disorder(30%), breathing difficulty(15%), bruxism(30%) and snoring(33%) was shown. Most people with cerebral palsy can't brush alone and didn't use oral care adjunctive supplies. Moreover, Fifty-nine percent of them were noncooperative to dental treatment.

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Volunteering, Hypertension Risks, and Related Phenomena: A Prospective Cohort Study (자원봉사활동과 고혈압 및 관련 현상과의 전향적 연구)

  • Lee, Hyunkee
    • 한국노년학
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    • v.41 no.3
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    • pp.397-420
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    • 2021
  • The paper tried to determine relationships between volunteering and hypertension risks, symptom betterment, activity difficulty occurrences, and medicine treatment among middle-aged and older adults, with a prospective cohort study. Multilevel mixed-effects generalized linear models were used for the analysis of longitudinal panel data collected over 10 years from 2008 to 2018, using 5,867 cohort samples. The results showed that those who volunteered at least 200 hours per year were 3.4 times more lower than not-volunteering in risks of hypertension, those who volunteered yearly 50~99 hours were a lot more improved than not-volunteering in the symptom betterment, those who volunteered yearly at least 200 hours were 7.7 times lower than not-volunteering in activity difficulty occurrences, and those who volunteered yearly 50~99 hours were 2.5 times lower than not-volunteering in the occurrences of medicine treatment. These indicate that volunteering among middle-aged and older adults may have health benefits against incident hypertension. Finally the thesis discusses the study limitations, future directions of studies, and the practices implications.

A Case Report of Patient Suffering from Cough and Dyspnea after Lung Transplantation Treated with Complex Korean Medicine (기침 및 호흡곤란을 호소하는 폐 이식 환자의 복합 한방 치험 1례)

  • Seyeon Lee;Kibeom Ku;Mariah Kim;Irang Nam;Minhwa Kim;Changwoo Han;In Lee;Jinwoo Hong;Jungnam Kwon;Soyeon Kim;Youngju Yun;Sojung Park;Junyong Choi
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1101-1108
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    • 2023
  • We report the case of a lung transplantation patient whose cough and dyspnea symptoms improved after receiving complex Korean medicine treatment. Lung transplantation provides a solution to many end-stage patients with lung disease who are refractory to conventional treatment, but the five-year survival rate of lung transplantation remains around 50%, and even surviving patients suffer from side effects, including infection, respiratory difficulty, and gastrointestinal problems. A 66-year-old woman with rheumatoid arthritis-interstitial lung disease was advised to undergo lung transplantation surgery when she suffered from dyspnea and failing respiratory symptoms after being diagnosed with COVID-19 and contracting pneumonia. Approximately five months after receiving a bilateral lung transplantation operation, she experienced acute pulmonary thromboembolism, and even after receiving anticoagulation therapy, she still struggled with cough and respiratory difficulty. After she received complex Korean medicine treatments, including herbal medicine, cupping therapy, and electrical moxibustion, we observed a decrease in inflammation, alleviation of symptoms such as cough and dyspnea, and improvement of pulmonary function and exercise capacity.

The Controversy Regarding the Optimal Management of Chronic Low Back Pain: Interventional vs. Medical Treatment (만성요통의 적정 치료를 둘러싼 논란: 중재적 치료 대 보존적 치료)

  • Kwon, O-Hyun
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.1-2
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    • 2010
  • Chronic non-specific low back pain (CLBP) is one of the major health problems casting substantial amount of economic expenses and negative impact on quality of life onto an individual as well as society. On contrary to public familiarity, the ways of management of CLBP are diverse and there is yet no general consensus about which approach is better than others or to whom the specific management should be applied. Some hold the negative point of view on the efficacy of the invasive maneuver such as epidural injection because there is no controlled clinical trial (RCT) yielding better long term outcome of those invasive managements over conservative ones. But the experts of interventional or surgical treatment stress the methodological difficulty in performing RCT and assert that those invasive treatments can bring the prompt and complete resolution of low back pain and restoration of function in appropriately selected cases. These seemingly opposite views on the invasive management on CLBP are rather complimentary each other than to be contradictory.

A Clinical Case Study on the Postpartum Depression (산후 우울증 환자 1례에 대한 증례보고)

  • Nam, Se-Hyeon;Lee, Hyun
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.9-16
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    • 2007
  • Postpartum depression is a kind of serious problem which influences on the postpartum woman, her family and infant. It has been known to be caused by many factors and some depression scales have been used to assess the degree of postpartum depression. Edinburgh postnatal depression scale(EPDS) is simple and efficient method. Because of the difficulty of diagnosis and valuation on the postpartum depression, there has been a few case report on oriental medical treatment. I report one postpartum depression case which was valuated by EPDS and had objective evidence. In this case herbal treatment and acupuncture was efficacious on the postpartum depression. I think, though six month has passed from parturition, there need to be treated after parturition weakness and deficiency point of view.

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임상가를 위한 특집 2 - 선천성 기형환자에서의 악교정수술 적용과 수술 증례 분석

  • Jung, Hwi-Dong;Jung, Young-Soo
    • The Journal of the Korean dental association
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    • v.50 no.11
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    • pp.670-676
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    • 2012
  • Distraction osteogenesis and orthognathic surgery are the widely used surgical methods for treating hemifacial microsomia and cleft lip and palate, the representative forms of congenital deformity. Distraction osteogenesis is an outstanding treatment of choice when more traction is needed than what can be achieved by general orthognathic surgery. However, the stability of distraction osteogenesis has not yet been established, and in most of the cases, additional orthognathic surgery is mandatory. Moreover, the difficulty in precise control of the traction directions is another disadvantage of distraction osteogenesis. Therefore, it would be desirable not to conduct distraction osteogenesis when the patient is suitable for an orthognathic surgery. Also, distraction osteogenesis should be recognized as an accessorial method of treatment, and be used restrictively.

Intravenous Target Controlled Infusion Sedation for Patients with Amyotrophic Lateral Sclerosis: Case Report (근위축성 측삭경화증 환자(ALS)의 치과 진료 시 목표농도 주입법을 이용한 정주 진정 마취: 증례 보고)

  • Doh, Re-Mee;Kim, Seung-Oh
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.3
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    • pp.177-181
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    • 2012
  • Amyotrophic lateral sclerosis (ALS) is one of the major neurodegenerative diseases that involves degeneration at all levels of the motor system- from the cortex to the anterior horn of the spinal cord. Patients with ALS often have difficulty of ambulation for dental treatment though they have poor oral hygiene state. General anesthesia may cause respiratory problem due to its high sensitivity to muscle relaxant and weakened upper airway. In this case report, 38-year-old female patient with ALS required many dental treatments. Conscious sedation with intravenous target controlled infusion method was successfully employed and patient was discharged without any complications.

Reverse Total Shoulder Arthroplasty in the Massive Rotator Cuff Tear

  • Jeong, Jin Young;Cha, Hong Eun
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.145-150
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    • 2014
  • In the patients of retracted massive rotator cuff tears, there are much of difficulty to functional recovery and pain relief. Nevertheless the development of treatment, there are still debates of the best treatments in the massive rotator cuff tears. Recenlty various of treatments are introduced; these are acromioplasty with debridement, biceps tenotomy, great tuberoplasty with biceps tenotomy, partial repair, mini-open rotator cuff repair, arthroscopic rotator cuff repair, soft tissue augmentation, tendon transfer, flap, hemiarthroplasty, and reverse total shoulder arthroplasty. That there is no difference of result for reverse total shoulder arthroplasty between patients who have massive rotator cuff tear without arthritis and patients who have cuff tear arthropathy. Reverse total shoulder arthroplasty is one of reliable and successful treatment options for massive rotator cuff tear. Especially it is more effective for patients who have a pseudoparalysis.