• Title/Summary/Keyword: Patient care report

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Treatment with upper complete denture and lower implant-fixed restorations on an elderly patient presenting fully edentulous maxilla and bilateral posterior edentulous mandible: a case report (상악 완전무치악 및 하악 양측 구치부 결손 고령환자에 대한 상악 가철성, 하악 고정성 보철치료: 증례보고)

  • Joseph Junesirk Choi;Richard Leesungbok;Suk-Won Lee;Phyo Ei Ei Htay;Jeong-yun Park;Jin-Young Chon
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.284-292
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    • 2023
  • Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient's posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.

A Case Study of Soeumin with Peripheral T-cell Lymphoma who Showed Symptomatic Improvement including Fever, Myalgia, Performance Status, and Headache after Treated with Osuyubujaijung-tang and Geopoong-san (오수유부자이중탕(吳茱萸附子理中湯) 및 거풍산(祛風散)으로 발열, 통증, 전신활동도, 두통 호전을 보인 소음인 말초성 T세포 림프종 환자 1례)

  • Choi, Seong-Heon;Song, An-Na;An, Ji-Hye;Kim, Eun-Hee;Park, So-Jeong;Kim, Kyung-Suk;Lee, Soo-Kyung
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.4
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    • pp.100-108
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    • 2012
  • Objectives : The aim of this study was to report the improvement of fever, myalgia, performance status, and headache after treatment with Osuyubujaijung-tang and Geopoong-san in a Soeumin with Peripheral T-cell lymphoma. Methods : We retrospectively reviewed the medical records, medical laboratory and image scans of 80-year-old male patient diagnosed as peripheral T-cell lymphoma. He couldn't conduct any conventional chemotherapy due to poor performance status, ECOG 4. Results : The symptoms of myalgia, poor performance status, and neck pain improved, and fever was reduced with Osuyubujaijung-tang. Headache was subsided with Geopoong-san. Conclusions : A patient with peripheral T-cell lymphoma suffering from fever, myalgia, poor performance status, neck pain and headache showed the improvement of symptoms with treatment of Osuyubujaijung-tang and Geopoong-san. After 4 months treatment, the patient could conduct self care, physical activity and social affairs.

THE MANAGEMENT OF TONGUE BITE IN A PATIENT OF CEREBRAL PALSY AFTER DENTAL TREATMENT UNDER GENERAL ANESTHESIA -CASE REPORTT- (뇌성마비환자의 전신마취 하 치과치료 후 혀 깨물기 손상 관리)

  • Shin, Teo-Jeon;Seo, Kwang-Suk;Kim, Hyun-Jeong;Park, Sung-Soo;Kim, Hye-Jeong;Yang, So-Young
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.6 no.2
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    • pp.116-119
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    • 2010
  • Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

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Massive barium sulfate aspiration during upper gastrointestinal contrast material study in an elderly patient with dysphagia

  • Yun, Hae Ryong;Kim, Chang-gon;Park, Jihye;Park, Yong eun;lee, Yong-il;Yoo, Byung-Woo;Chung, Kyung Soo;Kim, Young Sam;Song, Joo Han
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.162-165
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    • 2016
  • Barium sulfate is an inert material used as a radiographic contrast medium during upper gastrointestinal contrast studies for evaluation of patients with dysphagia. Oral barium aspiration is an uncommon but well-reported complication of this procedure. While barium aspiration of small amounts may not cause any symptoms, massive barium aspiration can be life-threatening, particularly in elderly patients with multiple comorbidities. In this case report, we describe an elderly patient with multiple comorbidities who presented with thyrotoxicosis and dysphagia, and then died after massive barium aspiration. Despite administration of intensive medical care with ventilator support and therapeutic bronchoalveolar lavage to remove the aspirated barium, the patient died of multiple organ failure 9 days after barium aspiration. Clinicians should pay attention to elderly patients with predisposing factors for aspiration in whom upper gastrointestinal barium contrast studies are indicated, and should consider other diagnostic tools for evaluation of dysphagia in this population.

Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury (둔상성 간손상 환자의 손상 통제술 후 발생한 심낭압전)

  • Ye, Jin Bong;Sul, Young Hoon;Go, Seung Je;Kwon, Oh Sang;Kim, Joong Suck;Park, ang Soon;Ku, Gwan Woo;Lee, Min Koo;Kim, Yeong Cheol
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.211-214
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    • 2015
  • The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment. Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.

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A Gunshot Wounds to the Cervical Spine and the Cervical Spinal Cord: A Case Report (총상으로 인한 경추부 및 척수손상: 증례 보고)

  • Paeng, Sung Hwa
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.57-62
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    • 2012
  • Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine, so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb$^{(R)}$. Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.

Early cicatricial lagophthalmos release with pentagonal wedge resection of the scar, fat redistribution, and full-thickness skin grafting

  • Chung, Chan Min;Tak, Seung Wan;Lim, Hyoseob;Cho, Sang-Hun;Lee, Jong Wook
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.49-52
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    • 2020
  • The specialized structure of the upper eyelid ensures complete closure of the eye and eyeball sealing. An upper eyelid injury can cause various symptoms associated with eyeball trauma, not just scar formation or eyelid deformity. In this report, we describe a case of lagophthalmos observed after wound repair in a patient with a crushing injury caused by a grinder. Several surgical techniques are used to treat lagophthalmos or scar contracture. In most cases, a releasing procedure is performed after 6 months of initial repair. However, if the patient has severe symptoms that are not relieved by conservative care, early revision is inevitable. We describe a case of early lagophthalmos successfully resolved with pentagonal wedge resection, fat redistribution, and full-thickness skin grafting. After the revisional surgery, we observed that the patient regained the ability to completely close the injured eyelid, with restoration of function and favorable cosmetic outcomes. Pentagonal wedge resection to release a retracted structure, fat redistribution to prevent readhesion, and full-thickness skin grafting for enough amount of skin to regain upper eyelid function is useful for scar release and lagophthalmos following crushing injuries of the upper eyelid.

Treatment of life-threatening acute osteomyelitis of the jaw during chemotherapy: a case report

  • Jung, Junhong;Kim, Sumin;Park, Jun-Sang;Lee, Choi-Ryang;Jeon, Jae-ho;Kwon, Ik-Jae;Myoung, Hoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.251-259
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    • 2020
  • Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.

Recurrent Brain Abscess In Chronic Sinusitis : A Case Report (만성부비동염을 가진 환자에서 재발된 뇌농양 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.275-279
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    • 2018
  • A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

THE INFECTION CONTROL METHOD FOR EARLY RADIATION THERAPY IN THE HEAD & NECK CANCER PATIENTS WITH ADVANCED ODONTOGENIC INFECTIOUS LESIONS : REPORT OF CASES (진행성 치성감염 병소들을 가진 두경부 악성종양 환자에서 조기 방사선치료를 위한 치성감염 조절법 : 증례보고)

  • Yoo, Jae-Ha;Lee, Jong-Young;Chung, Won-Gyun;Kim, Young-Nam;Jang, Sun-Ok;Jeon, Hyun-Sun;Kim, Jong-Bae;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.168-173
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    • 2006
  • The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.