• Title/Summary/Keyword: Shock patient

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Case Report of Treatment with Korean Medicine on a Central Post-Stroke Pain Patient who had Impingement Syndrome of the Right Shoulder (우측 어깨의 충격증후군을 동반한 뇌졸중 후 중추성 통증 환자 치험 1례)

  • Lim, Hyun-chan;Kim, Tae-ryun;Lee, Hye-in;Kim, Eun-ji;Lee, Da-eun;Jeon, Sang-yoon
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.1060-1067
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    • 2017
  • Objectives: This case study examined the effects of treatment with traditional Korean medicine on a central post-stroke pain patient, who had impingement syndrome of the right shoulder. Methods: The patient received traditional Korean medical treatments, including acupuncture, warm-needling, moxibustion, and cupping, throughout the treatment period, and extracorporeal shock-wave therapy and physical therapy for part of the treatment period. The effects of treatments were measured with a manual muscle test (MMT), numerical rating scale (NRS), range of motion (ROM), and gait staging index (self-invented). Results: The clinical symptoms of the patient were improved considerably after the complete treatment. Conclusions: Traditional Korean medicine may be effective for treatment of central post-stroke pain in patients with impingement syndrome.

Emergency Coronary Artery Bypass Operation for Card iogen ic Shock (심인성 쇼크에 대한 응급 관상동맥 우회술)

  • 김응중;이원용
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.966-972
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    • 1997
  • Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.

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Catastrophic catecholamine-induced cardiomyopathy rescued by extracorporeal membrane oxygenation in recurrent malignant pheochromocytoma

  • Min, Daniel
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.254-259
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    • 2019
  • Pheochromocytoma (PCC) is a rare catecholamine-producing tumor with the incidence in hypertension of 0.1-0.6%. PCC crisis is an endocrine emergency that can lead to hemodynamic disturbance and organ failure such as catecholamine-induced cardiomyopathy. The circulatory collapse caused by it often requires mechanical support. The author reports an unusual case in which a patient who previously underwent surgery for malignant PCC developed catecholamine-induced cardiomyopathy, and successfully recovered using extracorporeal membrane oxygenation.

A case of rescuing a patient with acute cardiovascular instability from sudden and massive intraoperative pulmonary thromboembolism by extracorporeal membrane oxygenation

  • Kim, Won Jin;Kang, Jin Gu
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.477-482
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    • 2018
  • Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

Acoustic outputs from clinical extracorporeal shock wave lithotripsy devices (임상에서 사용중인 체외충격파쇄석기의 음향 출력 분포)

  • Jong Min Kim;Oh Bin Kwon;Jin Sik Cho;Sung Joung Jeon;Ki Il Nam;Sung Yong Cho;Min Joo Choi
    • The Journal of the Acoustical Society of Korea
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    • v.42 no.5
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    • pp.469-490
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    • 2023
  • Survey was carried out on the acoustic outputs from 12 shock wave fields produced by the 10 extracorporeal shock wave lithotriptors whose technical documents are available, among the 33 devices approved by the Ministry of Food & Drug Safety (MFDS).The results show that the acoustic outputs (P+, P-, efd, and E), critical to the therapeutic efficacy and the patient safety, are largely different between the devices. The maximum values of P+, P-, efd, and E vary up to 2.08, 3.72, 3.89, and 15.98 times, respectively. The acoustic output parameters are not thoroughly provided in the technical documents, and some of data (eg. efd) are suspected to be abnormal outside usual ranges. The large device to device differences in the shock wave outputs are likely to undermine equivalence between the ESWL devices approved for the same indication. To verify the reliability of the data in the technical documents of the approved devices and to confirm if the acoustic outputs from the devices in clinical use are the same as those in their technical documents, an authorized test laboratory should be available. A postapproval monitoring led by the regulatory agency is suggested to maintain the acoustic outputs from the ESWL devices that suffer from degrading in performance due to aging.

Acute Rotator Cuff Tears due to Low Voltage Electrical Injury: A Case Report

  • Yoo, Jae Hyun;Rhee, Sung-Min;Shim, Ho Yong;Lee, Jae Sung
    • Clinics in Shoulder and Elbow
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    • v.21 no.2
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    • pp.101-104
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    • 2018
  • Since shoulder have a higher proportion of muscle which would have low electrical resistance, there could be more electrical damage to the rotator cuff muscles. We present a patient with acute rotator cuff tear by sudden uncontrolled jerking contractions caused by an electrical shock. A case of 42-year-old man with acute rotator cuff tear due to electrical injury to the shoulder was presented. Magnetic resonance imaging showed a full thickness tear and an undulating appearance of the peripheral end of the torn supraspinatus and infraspinatus muscle, suggesting an acute complete rupture. By arthroscopic surgery, the torn rotator cuff tendons were repaired with a suture bridge technique. At the final follow-up, the patient had a full, pain-free range of motion and had fully recovered shoulder muscle power.

A Case of a Yolgwol Headache with Bacteremia (균혈증(菌血症)을 동반(同伴)한 열궐두통(熱厥頭痛)의 치험(治驗) 1례(例))

  • Kim, Ja-Young;Lee, Ji-Young;Wang, Teh-Chung;Ahn, Dae-Jong
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.321-330
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    • 2007
  • Bacteremia is the transient presence of bacteria (or other microorganisms) in the blood. Bacteremia may result no symptom to the healthy persons, but it may result symptoms such as pylexia, headache and even septic shock to the patient in immunosuppression. In this case, a 75 years old male patient had a dental caries and cerebrovascular accident ago, therefore was in a bad condition and often caught cough. Suddenly be bad a headache with a high fever caused by Streptococcus Mutans Bateremia. After defervescence, a slight fever and a headache remained. It may the symptoms of Yolgwol headache(熱厥頭痛) , so Cbeougsaugsabwa-taug(淸上瀉火湯), the symptoms such as a slight fever and a headache are on the mend.

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Percutaneous Cardiopulmonary Bypass Support in a Patient with Acute Myocardial Infarction by Stent Thrombosis Complicated with Ventricular Tachycardia (스텐트 혈전에 의한 재발성 심실성 빈맥을 동반한 급성 심근경색에 경피적 심폐순환보조)

  • Kim Sang-Pil;Lee Jun-Wan
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.399-402
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    • 2006
  • Stent thrombosis is a rare complication after percutaneous coronary intervention (PCI), but it might be related to fatal outcomes. We report a case of patient who suffered from acute myocardial infarction complicated with cardiogenic shock and ventricular tachycardia caused by stent thrombosis and successfully resuscitated by percutaneous cardiopulmonary bypass support.

Positioning of Resuscitative Endovascular Balloon Occlusion of the Aorta Catheter: A Case of an Elderly Patient with Concomitant Chest and Pelvic Injury after Blunt Trauma

  • Noh, Dongsub;Yun, Jeongseok;Chang, Ye Rim
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.186-190
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used in recent years as a resuscitative adjunct for trauma patients with life-threatening non-compressible torso hemorrhage. By blocking the aorta temporarily with an inflated balloon, REBOA preserves cerebral and coronary perfusion while diminishing exsanguination below the balloon, thereby providing time for resuscitation and definitive bleeding control. When determining the occlusion zone during the REBOA procedure, factors such tortuosity of the aorta, co-occurring minor chest injuries, and the severity of shock must be considered, as well as the main injury site. This paper describes a case of high Zone I REBOA in an elderly patient with a tortuous aorta who had concomitant injuries of the chest and pelvis.

Management of a Gunshot Wound at the Temporal Region: Case Report (측두 부위의 총상 환자에 대한 처치: 증례보고)

  • Lee, Ju-Min;Ahn, Kyung-Yong;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.81-84
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    • 2012
  • Gunshot wounds are unpredictable and require early, precise diagnosis and treatment. A penetrating gunshot wound can be fatal due to compromised airway, hypovolemic shock, lead poisoning and infection. This case report describes a 48-year-old male patient who had a suicidal gunshot wound on the right temporomandibular joint area using an air rifle. We successfully managed the patient by preoperative embolization, surgical removal of the foreign body and primary closure.