• 제목/요약/키워드: unconscious patient

검색결과 45건 처리시간 0.024초

장시간 심폐소생술을 요한 초오중독에 의한 심정지 1례 (Prolonged Cardiopulmonary Resuscitation in a Cardiac Arrest Patient with Aconitine Intoxication)

  • 황인우;정태오;이재백;진영호
    • 대한임상독성학회지
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    • 제5권1호
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    • pp.67-70
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    • 2007
  • Aconitum is an extremely dangerous plant that contains various toxic diterpenoid alkaloids, primarily concentrated in the roots. We report a case of acute intoxication of a 60-year-old man admitted to our emergency department after ingestion of a large amount of homemade aconitine decoction. At presentation about one hour after intake, the patient was unconscious and electrocardiographic analysis showed a ventricular tachycardia/fibrillation. Several times defibrillation was applied and antiarrhythmic agents were administered, but the patient still exhibited a refractory ventricular fibrillation and failed to return to spontaneous circulation. Sustained cardiopulmonary resuscitation finally produced a pulsatile cardiac rhythm at two hours after intake. The patient was discharged from our hospital on day 8. The authors stress that clinicians must be aware of the possible occurrence of life-threatening ventricular arrhythmia in cases of aconitine intoxication and be prepared to persist with prolonged CPR as necessary.

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아동학대로 인해 발생한 중증 단백-에너지 영양실조 환아에서 동반된 구리결핍증 빈혈 1예 (Copper Deficient Anemia in Severe Protein-Energy Malnutrition due to Child Abuse)

  • 변성환;전제덕;장수희
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권1호
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    • pp.60-65
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    • 2007
  • 저자들은 가족 내에서 아동학대로 인해 발생한 치명적인 중증 영양실조를 보인 5세 여아에 동반된 빈혈과 구리 결핍증을 WHO 치료 지침과 구리 보충요법으로 호전시킨 1예를 치험하였기에 보고하는 바이다.

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원인 불명의 급성 신부전으로 발현된 급성 파라콰트중독 1례 (A case of Diagnosing Paraquat Intoxication on Transferred Patient with Acute Renal Failure)

  • 길효욱;양종오;이은영;홍세용
    • 대한임상독성학회지
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    • 제2권1호
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    • pp.45-48
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    • 2004
  • Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in human. Many treatment modality has been used, but now paraquat is very fatal drug. Elimination rate of plasma paraquat seems to be a factor for the survival rate. So early diagnosis and early treatment are very important. Plasma paraquat concentration could be measured by radioimmunoassay. But it is impossible that the test was done at Emergency room and the result was checked immediately. There was relation between plasma paraquat concentrations and urine paraquat concentration. Because of its simplicity and low cost, urine paraquat concentration test is complementary to the plasma concentration measurement. If the patient has psychotic problem or unconscious mental state, and is observed unexplained dyspnea and oral ulcer, urine paraquat test is very important to rule out acute paraquat intoxication. We experienced a patient who was presented as unexplained acute renal failure initially and was diagnosed as paraquat intoxication later.

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흉부 경막외 차단 시 발생된 우발적 전척추마취 -증례 보고- (Accidental Total Spinal Anesthesia Following Thoracic Epidural Block -A case report-)

  • 양세호;장영호;전재규
    • The Korean Journal of Pain
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    • 제14권2호
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    • pp.249-252
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    • 2001
  • Total spinal anesthesia is a serious life threatening complication of spinal and epidural anesthesia. We report an accidental total spinal anesthesia developed during a thoracic epidural block in a practitioner's pain clinic. A 69-year-old female with post-herpetic neuralgia was treated by a thoracic epidural block. A thoracic tapping for the epidural block was performed in the right lateral position at a level between $T_{5-6}$, using a 23 gauge Tuohy needle. After the epidural space was identified, a mixed solution of 10 ml of 0.3% lidocaine and 20 mg of triamcinolone was injected into the epidural space. After removal of the syringe, fluid was dripping through the needle. The patient subsequently complained of dyspnea and dizziness, and she became unconscious. She was intubated immediately and cardiopulmonary resuscitation was performed because there was no pulse palpable. The patient recovered an hour after transfer to a general hospital and was discharged without any further complication 19 days later.

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오심(惡心), 구토(嘔吐)를 주소(主訴)로 하는 신체형(身體型) 장애(障碍) 환아(患兒)의 치험(治驗) 1예(例) (A clinical case report of somatoform disorder patient complained nausea and vomiting)

  • 한륜정;장규태;김장현
    • 대한한방소아과학회지
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    • 제15권2호
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    • pp.201-208
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    • 2001
  • The somatoform disorder are distinguished by physical symptoms suggesting a medical condition, yet the symptoms are not fully explained by the medical condition, by substance use, or by another mental disorder. This is that an unconscious intrapsychic conflict, wish, or need is converted to a somatic symptom and clinically express various symptoms such as headache, dizziness, nausea, vomiting dyspepsia, diarrhea and constipation, etc. We report a case of somatoform disorder patient, who was 9 years old female and complained of nausea, vomiting and dysdipsia. She had her case diagnosed as somatoform disorder in Yong-dong severance hospital and took anti-depressant (chlomipramine) with counseling for 2 months. After treatment, her emotional instability and depression were improved, yet the somatic symptoms remain same. We diagnosed her case as vomiting induced by deficiency of the stomach(胃虛嘔吐) and administered Bihe-yin(比和飮) to her. After administration of Bihe-yin(比和飮) for one month, her somatic symptoms of nausea, vomiting and dysdipsia were almost disappeared and she got acquired her confidence in school life.

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Rod Migration into the Posterior Fossa after Harms Operation : Case Report and Review of Literatures

  • Chun, Hyoung-Joon;Bak, Koang-Hum;Kang, Tae-Hoon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • 제47권3호
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    • pp.221-223
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    • 2010
  • C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.

급성 건 손상 환자에서 초음파의 유용성 (The Usefulness of Ultrasound Diagnosis of Acute Tendon Injury in Hand)

  • 최창용;이한정;최환준;김미선
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.729-734
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    • 2008
  • Purpose: The evaluation and management of a completely transected tendon of the hand is relatively clear. In most cases, the integrity is assessed by physical examination(eg, broken normal cascade, motion loss) but occasionally, It happens in troubles. because of pain, limited patient cooperation(eg, child, unconscious patient), and other associated injuries(eg, fractures, foreign bodies). Methods: From september 2006 to August 2007, 28 patients were evaluated with real time ultrasonography preoperatively and postoperatively. Twenty eight patients with injured tendon were evaluated using an HDI 5000 Sono CT(Philips Medical Systems, Bothell, WA) machine with a high resolution, 7.5MHz hockey stick linear probe. Dynamic evaluation was performed in real time. Results: Surgery was performed after the ultrasonographic evaluation. Sonographic diagnosis and intraoperative findings were correlated. Ultrasonographic findings show tendon discontinuity, gaps, and fluid collection. Conclusion: We conclude that ultrasonography is helpful in evaluating and managing acute tendon injury. Especially, in cases of completely lacerated tendon, ultrasonography can identify the location of the proximal tendon stump and partial lacerated tendon, ultrasonographic diagnostic tool can decrease misdiagnosis.

의식장애를 동반한 외상성 뇌내출혈 노인 환자의 한방치료 치험 1례 (A Case Study on Traditional Korean Medicine Therapy in an Elderly Patient with a Traumatic Intracerebral Hemorrhage)

  • 임명아;강다현;이희정;김두리;서호석;김진원;김판규
    • 대한한방내과학회지
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    • 제37권5호
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    • pp.885-892
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    • 2016
  • Few studies have reported the effects of traditional Korean medical (TKM) therapy in patients with traumatic brain hemorrhage. The patient was a 93-year-old female who was unconscious after a traumatic intracerebral hemorrhage (ICH) and was not a candidate for any surgical treatment because of her age. We treated her with acupuncture and herbal medicine. After 28 days of treatment, we observed an improvement in consciousness on the Glasgow Coma Scale (GCS) and in other symptoms (aphasia, weakness in both legs, and headache).

Recurrent Dorsal Compartment Syndrome of the Upper Arm After Blunt Trauma

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong;Yang, Jae-Hoon;Kim, Dong-Kyu;Cha, Soo-Min
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2009년도 제17차 학술대회
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    • pp.160-160
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    • 2009
  • Compartment syndrome is not uncommon in the forearm or lower extremity, but it is relatively rare in the upper arm. This rarity might delay the diagnosis, especially in the unconscious or intoxicated patient. Therefore, a high index of suspicion is needed to make an accurate, early diagnosis. Although excessive muscle strain leading to localized compartment syndrome is seldom encountered in the upper arm, three cases of compartment syndrome in the upper arm after blunt injury have been reported. Interestingly, there were no bony injuries in any of these patients. However, there are only two reports of isolated dorsal compartment syndrome after blunt trauma. The present report presents the case of a patient who had blunt trauma to the upper arm that resulted in the development of compartment syndrome in the isolated dorsal compartment of the upper arm.

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Contralateral Intraparenchymal Hemorrhage Following Aneurysmal Clipping

  • Kim, Jae-Hoon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • 제43권3호
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    • pp.162-164
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    • 2008
  • Post-clipping intraparenchymal hemorrhage of the contralateral hemisphere is a very unusual phenomenon in a patient with aneurysmal subarachnoid hemorrhage, unless there is an underlying condition. We report a complicated case of 47-year-old man, who underwent uneventful clipping of ruptured aneurysm and experienced vasospasm two weeks later. Vasospasm was treated by intra-arterial nimodipine and systemic hyperdynamic therapy. One week thereafter, he became unconscious due to intraparenchymal hemorrhage on the anterior border-zone of contalateral hemisphere, but intraoperative and pathologic findings failed to disclose any vascular anomaly. We suggest that the anti-spastic regimens cause local hemodynamic redistribution through the vasodilatory effect and in turn, resulted in such an unexpected bleeding.