• 제목/요약/키워드: Foreign patient

검색결과 357건 처리시간 0.028초

이하선 목재 이물 (Wooden Foreign Body in the Parotid Gland)

  • 문유진;최환준;김미선;최창용;박진규;김준혁
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.201-204
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    • 2008
  • Purpose: Now the CT scanner and PACS program proved to be an excellent instrument for detection and localization of most facial foreign bodies above certain minimum levels of detectability. The severity of injury in penetrating trauma on the face is often underestimated in physical examination. Wood, with its porous consistency and organic nature, provides a good medium for microbial agents. This is a report of our recent experience with wooden foreign bodies in the parotid gland imaged with CT. Methods: A 9-year-old boy was referred for evaluation of possible retained foreign body within his face. One day earlier, he had fallen, face down approximately 1 miter onto ground. He had subsequently undergone an exploration of his right parotido-masseteric area at an outside hospital with repair of a right facial laceration. Enhanced 2 mm axial and coronal CT scans were obtained through the face. Axial and coronal CT images were obtained with a General Electric(Milwaukee, Wis) 9800 CT scanner at 130 kV, 90 mA, with a 2 mm section thickness. Results: We finally decided the linear "gas" attenuation was a foreign body because of its linear configuration, which did not conform to that of an anatomic structure, and on the basis of articles that described a wood foreign body in the orbit as having the appearance of air. We found that wood was hypoattenuating($-464{\pm}27HU$). Conclusion: We recommend this type of software program for CT scanning for any patient with an injury on the face in which a foreign body is suspected.

외국인 환자 간호조직 실태 조사 (A Survey on Nursing Organizational Service for Foreign Patients in Tertiary Hospitals)

  • 김금순;최윤경;안정원;정은희;김을순
    • 임상간호연구
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    • 제21권1호
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    • pp.53-66
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    • 2015
  • Purpose: The purpose of this study was to investigate the status of organizational nursing service for foreign patients in tertiary hospitals in order to build up a database for nursing care policy development for foreign patients. Methods: The subjects of this study were nursing managers or department managers of international care center in 36 tertiary hospitals nationwide. Questionnaires were consisted of the items measuring the details of and evaluations for nursing care for foreign patients within the given organizations and any organizational support for culturally competent care. The data from 35 hospitals out of 36 were analyzed finally. Results: The organizational nursing service for foreign patients was rated 6.49 points out of 10. Organizational support for culturally competent care was 2.61 points out of 4. Challenges to improving nursing care for foreign patients were listed such as developing interpreter services and international care units without accompanying by a family member, improving nursing staffs' attitudes and behaviors for providing culturally competent care, and preparing various medical documents using multiple languages. Conclusion: In order to improve nursing care for foreign patients in tertiary hospitals, we need to be more aware of cultural knowledge and sensitivity toward the care needs of foreign patients.

인천 지역 소아에서 기도 내 이물 흡인의 임상적 고찰 (Clinical characteristics of foreign body aspiration in children in Incheon city, Korea)

  • 김선;오경진;김정희;선용한;임대현
    • Allergy, Asthma & Respiratory Disease
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    • 제6권6호
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    • pp.303-309
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    • 2018
  • Purpose: Foreign body aspiration in children is emergent and can cause serious complications. This study aims to show the clinical characteristics of foreign body aspiration and to analyze the clinical cases of delayed diagnosis to predict and prevent complications. Methods: We retrospectively reviewed the medical records of 63 children (48 in Inha University Hospital and 15 in Gachon University Gil Medical Center) who were diagnosed with foreign body aspiration through bronchoscopy from 1996 to 2017 in Incheon City, and analyzed clinical characteristics. Patients were divided into 3 groups: those were diagnosed within 24 hours, delayed after 24 hours, or delayed more than 7 days according to time elapse from the time of foreign body aspiration, and clinical characteristics of each group were compared. Results: Aspiration occurred in 58.7% at 1 year and 15.9% at 2 years. Cough (65.1%) and coarse breathing sound (41.3%) were most common, and radiologic findings were commonly presented as emphysema on the affected side (41.3%). Nuts were most common (42.9%), and there was no difference in the frequency between the right and left main bronchi. The documented history of foreign body aspiration was more frequently found in the early diagnosed group; however, sputum, fever, and complications were more frequent in the delayed diagnosed group. Conclusion: If a patient with respiratory disease has persistent fever or sputum, foreign body aspiration should be suspected.

Detection of different foreign bodies in the maxillofacial region with spiral computed tomography and cone-beam computed tomography: An in vitro study

  • Abolvardi, Masoud;Akhlaghian, Marzieh;Shishvan, Hadi Hamidi;Dastan, Farivar
    • Imaging Science in Dentistry
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    • 제50권4호
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    • pp.291-298
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    • 2020
  • Purpose: The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods: In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results: CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion: Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.

심장 관통상 후 잔류한 심장 내 이물질의 수술적 제거 (Surgical Removal of Intracardiac Foreign Body Remained after Penetrating Cardiac Injury)

  • 박국양;박철현;최창휴;이재익;전양빈
    • Journal of Trauma and Injury
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    • 제25권4호
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    • pp.267-270
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    • 2012
  • A 27 year-old man, who had a penetrating cardiac injury due to a metal fragment was transferred to our hospital. At admission, his vital signs were stable, and his chest film showed a foreign-body-like finding in the heart silhouette. We evaluated the patient with chest computed tomography and echocardiography for further information. Finally, we removed the metal fragment from the left ventricle by using a cardiopulmonary bypass.

2개월간 식도에 체류하였던 백일 금반지 1례 (A Case of Gold Ring Lodged in Esophagus for 2 Months)

  • 김중환;오경균;정완교;이상기;김정배;길동석;서정하
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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    • pp.6.1-6
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    • 1983
  • 식도 이물은 순간적인 부주의로 우리생활 주변에서 흔히 볼 수 있으며 대부분의 경우 곧 제거하게 된다. 그러나 보호자의 무지, 환자가 연소자인 경우 및 치료자의 적극적인 진단이 결여된 경우 뒤늦게 발견되는 수가 있다. 최근 저자들은 생 후 5개월된 남아에서 백일기념 1돈중(3.75g중)금반지가 식도 제 2협착부에 2개월간 체류하였던 1례를 경험하였기에 보고하는 바이다.

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A Case of Unexpected Clinostomum complanatum Infection Initially Presenting as Foreign Body in Pharynx

  • Kim, Hyunjung;Cho, Sung-Weon;Oh, Harim;Byeon, Hyung Kwon
    • Parasites, Hosts and Diseases
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    • 제57권2호
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    • pp.175-177
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    • 2019
  • A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient's subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.

생명권과 자기결정권, 그리고 의사의 진료의무 (Death with Dignity and the Right to Decide)

  • 유승룡
    • 의료법학
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    • 제9권2호
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    • pp.11-52
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    • 2008
  • Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.

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안면부에 잔류된 다양한 이물질을 측정한 CT 계수 (CT Number Measurement of Residual Foreign Bodies in Face)

  • 위서영;최환준;김미선;최창용
    • Archives of Plastic Surgery
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    • 제35권4호
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    • pp.423-430
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    • 2008
  • Purpose: Computed tomography theoretically should improve detection of foreign bodies and provide more information of adjacent soft tissues. And the CT scanner and PACS program proved to be an excellent instrument for detection and localization of most facial foreign bodies above certain minimum levels of detectability. The severity of injury in penetrating trauma to the face, it is often underestimated by physical examination. Diagnosis of a retained foreign object is always critical. Methods: From March, 2005 to February 2008 a study was done with 200 patients who had facial trauma. Axial and coronal CT images were obtained with a General Electric(Milwaukee, Wis) 9800 CT scanner at 130 kV, 90 mA, with a 2-mm section thickness and a $512{\times}512$ matrix. Results: Axial and coronal CT images at various window widths should be used as the first imaging modality to detect facial foreign bodies. The attenuation coefficients for the metallic and nonmetallic foreign bodies ranged from -437 to +3071 HU. As a general rule, metallic foreign bodies produced more Hounsfield artifacts than nonmetallic foreign bodies, thus providing a clue to their composition. All of the metallic foreign bodies were represented by a single peak and had a maximum attenuation coefficient of +3071 HU. Of the nonmetallic foreign bodies, glass had an attenuation coefficient that ranged from +105 to +2039, while plastic had a much lower coefficient that ranged from -62 to -35. wood had the lowest range of attenuation coefficients: -491 to -437. Conclusion: The PACS program allows one to distinguish metallic from nonmetallic foreign bodies and to individually identify the specific composition of many nonmetallic foreign bodies. This program does not, however, allow identification of the specific composition of a metallic foreign body. We recommend this type of software program for CT scanning of any patient with an injury to the face in which a foreign body is suspected.

기도 이물의 임상적 고찰 (A Retrospective Review of Tracheobronchial Foreign Bodies)

  • 손창영;위정욱;김수옥;오인재;박창민;김규식;김유일;임성철;임상철;김영철;박경옥
    • Tuberculosis and Respiratory Diseases
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    • 제58권6호
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    • pp.600-606
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    • 2005
  • Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.