• Title/Summary/Keyword: 비출혈

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Detection of Acute Subarachnoid Hemorrhage: Comparison of FLAIR MR Imaging with Unenhanced CT (급성 거미막하 출혈의 진단: FLAIR MR영상과 조영전 CT와의 비교)

  • Choi, Won-Jin;Choi, Dae-Seob;Kim, Joung-Hae;Kim, Soon;Lee, Hyeon-Kyeong;Oh, Yoen-Hee;Kim, Seung-Hyeon;Lee, Sung-Woo;Kim, Wook-Nyeon;Lee, Kyu-Chun
    • Investigative Magnetic Resonance Imaging
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    • v.5 no.2
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    • pp.149-154
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    • 2001
  • Purpose : Our aim was to evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) MR imaging for detection of acute subarachnoid hemorrhage (SAH) compared with unenhanced CT. Materials and methods ; We compared FLAIR MR images with unenhanced CT scans in 28 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0 (absence), 1 (suspicious), 2 (definite) in the cerebral sulci, sylvian fissure, basal cistern, and cisterns of the posterior fossa. We also compared FLAIR MR images of 28 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. Results : FLAIR MR image was superior to CT in detecting SAH in the posterior fossa ($1.41{\pm}0.74{\;}vs{\;}0.78{\pm}0.80$; p<0.05) and cortical sulci ($1.11{\pm}0.80{\;}vs{\;}0.70{\pm}0.83$; p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cistern and sylvian fissure. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. Conclusion : FLAIR MR image is useful in detecting acute SAH, especially in patients with small amount of SAH or SAH in the posterior fossa.

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Effect of low-dose Aprotinin on Postoperative Bleeding and Renal Function after Cardiopulmonary Bypass (체외순환후 출혈감소와 신기능에 미치는 저용량 aprotinin효과)

  • 박철현;현성열;이현재;박국양;김주이;임창영
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.32-39
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    • 1998
  • High-dose aprotinin(Hammersmith regimen) has been widely used for years to control postoperative bleeding and reduce blood consumption in cardiac surgery but had known to cause some side-effects and had disadvantage in cost-effectiveness. The prospective controlled study of 33 patients undergoing cardiopulmonary bypass was performed to evaluate the efficacy for reducing postoperative bleeding and unfavorable effects of low-dose aprotinin. The level of hemoglobin and platelet in the blood and the amount of postoperative bleeding were assessed preoperatively, and postoperatively for the study of hemostatic function. The level of BUN and serum creatinine in the blood, levels of urine creatinine, total protein, albumin, alpha-1-microglobulin and creatinine clearance were assessed before and after the operation for the study of renal function. The aprotinin group had a significant reduction in chest tube drainage; 243$\pm$ 123 ml versus 406$\pm$303 ml(P=0.037) during 6 hours immediate-postoperatively, 494$\pm$358 ml versus 869$\pm$570 ml(P=0.045) during 24 hours postoperatively. The ratio of alpha-1-microglobulin/creatinine and microalbumin/creatinine in the urine were slightly increased in the aprotinin group postoperatively in comparison with the control group but there were no statistically significant difference(55$\pm$23 versus 24$\pm$10 in the alpha-1-microglobulin/creatinine, 56$\pm$19 versus 38$\pm$25 in the microalbumin/creatinine at post- operative 3rd day). There were no significant difference between two groups in other parameters of renal function, too. This study showed that low-dose aprotinin is an effective means of reducing postoperative bleeding without inducing significant renal dysfunction.

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Ameliorating Effects of Nokyongdaebo-tang on Experimental Subacute Hemorrhagic Anemia in Rats (녹용대보탕 열수 추출물의 실험적으로 유발된 랫트 아급성 출혈성 빈혈에 대한 효과)

  • Kim, Jung-Ah;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.3
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    • pp.1-19
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    • 2017
  • Objectives: The object of this study is to observe the possible ameliorating effects of Nokyongdaebo-tang (NYDBT) on the experimental subacute hemorrhagic anemia (SHA) in rats. Methods: In the present study, SHA in rats was induced by exsanguinations from orbital plexus, and ameliorating effects of NYDBT was observed based on the changes of body and hematopoietic organ (spleen, liver and femur) weights, red blood cell (RBC) related hematological values, smear cytology, histopathological changes and immunohistochemistrical analysis of hematopoietic stem cells in the femur bone marrow, liver and spleen. In addition, the gastrointestinal motility and the surface mucosa thicknesses of remnant fecal pellets in the colon lumen, mucosa thicknesses and the mucous producing cell numbers in the colonic mucosa were analyzed to observe the digestive disorders, especially on the constipation, the major discomfort problems in iron supplement. Results: SHA related abnormal anemic signs were markedly and dose-dependently inhibited by oral administration of NYDBT 500, 250 and 125 mg/kg in a condition of this experiment. In addition, no meaningful changes on the gastrointestinal motilities and mucous component on the colon and remnant feces were noticed in all three different dosages of NYDBT treated rats as compared with intact vehicle and SHA control rats in this study. Conclusions: It, therefore, is expected that NYDBT will be promising as a novel alternative hematopoietic and therapeutic agent for anemia.

A Case of the Angiofibroma of the Nasal Septum (비중격에 발생한 혈관섬유종 1례)

  • 권혁진;박호선
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.17.5-18
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    • 1983
  • Angiofibroma in otorhinolaryngologic field is rare, highly vascular and non-metastatizing benign tumor. It was noted as histologically benign but clinically malignant tumor because of the anatomical site, severe bleeding in surgery and recurrence in incomplete removal. It occurs almostly in nasopharynx of adolescent males. Recently, the authors have experienced a very rare case of angiofibroma which occupied the nasal septum in a 37-years-old-male with complaints of nasal obstruction and frequent nasal bleeding. The tumor mass was removed surgically through intranasal approach under local anesthesia. We report our case with review of current literatures.

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Splenic Arterial Embolization in Salvage of the Injured Spleen in Children (소아의 비장 손상시 비장 보존을 위한 비장동맥색전술)

  • Hong, Soon-Hoon;Yoo, Soo-Young;Park, Jin-Su;Kim, Young-Ju
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.15-25
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    • 1999
  • Injured spleens have been successfully managed without operation in a number of children; however, splenectomy or splenic-conserving surgery may not be avoided because of exsanguinating hemorrhage. This study was performed to evaluate the efficacy of splenic arterial embolization (SAE) to control hemorrhage from injured spleens in children. We compared the outcomes of two groups of children with splenic injury. The first group (G1) consisted of eighteen children who were managed with conventional selective nonoperative treatment between 1993 and 1994. The second group (G2) consisted of 23 children prospectively studied from 1996 to 1997 after SAE was added in the management protocol of splenic injury. The criteria for SAE were grade III or IV injury, extravasation of contrast material revealed by CT, or unstable vital signs without evidence of associated injuries. Laparotomy was performed in 6 patients of G1 (33.3 %), 2 of whom had associated injuries. Five underwent splenectomy and the overall salvage rate in G1 was 72.2 % (13/18). In G2, eight patients (34.8 %) had SAE, which stopped bleeding successfully in all patients. Two of G2 (8.7 %) had laparotomy because of associated injuries. Only one patient underwent splenectomy and the salvage rate was 95.6 % (22/23). No patients required transfusion after SAE. In conclusion, the SAE effectively controlled hemorrhage from injured spleens. More spleens were salvaged with a reduced laparotomy rate after application of SAE in splenic injury.

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Unusual MR Features of Extravasation of Contrast Material in Hyperacute Intracerebral Hemorrhage (초급성 두개내 출혈 환자에서 조영제의 혈관외 누출을 동반한 비전형적 자기공명영상)

  • Choi Seung Hong;Chun Woo Sun;Kim Ji-Hoon;Kang Hyun Seung;Kwon Bae Ju;Na Dong Gyu;Kim Jae Hyung;Han Moon Hee;Chang Kee-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.50-56
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    • 2005
  • Contrast extravasation in hyperacute intracerebral hemorrhage (ICH) indicative of active bleeding is a predictor of possible enlargement of hematoma, providing clinician with valid management decisions. We report unusual MR imaging features of contrast extravasation in hyperacute ICH in three patients: Case 1 with hypertension revealed dual foci of contrast extravasation, one in right basal ganglia and the other in left lateral ventricle, suggesting simultaneous bleeding of the two foci. Case 2 with presumed diagnosis of vasculitis showed relatively large area of contrast extravasation mimicking enhancing tumor or vascular lesion. Case 3 with hypertension showed the findings of active bleeding which was likely to occur during the time of MR imaging acquisition.

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The Effect of Antifibrinolytic Therapy in Prevention of Rebleeding before Early Aneurysm Surgery (뇌동맥류의 조기수술 전 재출혈 방지를 위한 항섬유소용해제 투여의 효과)

  • Lee, Chang Young;Yim, Man Bin;Lee, Jang Chull;Son, Eun Ik;Kim, Dong Won;Kim, In Hong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1065-1071
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    • 2001
  • Object : This study was conducted to evaluate whether short-term intravenous infusion of tranexamic acid (AMCA) was able to improve the management outcome by preventing rebleeding without increasing vasospasm and hydrocephalus associated with the long-term administration of this agent in the patients with aneurysmal subarachnoid hemorrhage(SAH) who were planned for the early surgery. Methods : During the period from June, 1996 to May, 1998, 137 patients admitted within 3 days of their SAH and planned for early surgical intervention were subject to study population. Of these, 60 patients who had been treated with AMCA were classified as AMCA treated group and 77 patients without AMCA treatment as AMCA untreated group. Initially, prognostic factors for rebleeding, vasospasm, hydrocephalus and outcome following SAH including age, sex, clinical grade, CT grade, site of ruptured aneurysms, admission day after SAH, surgery day after SAH, number of aneurysms and hypertension history, were analyzed and compared between AMCA treated group and untreated group. Secondly, the incidence of rebleeding, symptomatic vasospasm and hydrocephalus were compared between the two groups. Also, the management outcome of the patients was compared between the two groups. Results : There were no significant differences in prognostic factors between the two groups. The rebleeding rate was 0% in the AMCA treated group whereas the rate was 7.8% in the untreated group. This difference was statistically significant. The incidences of symptomatic vasospasm and hydrocephalus were found not to be significantly different between the two groups. Of the treated group, 31.7% of patients developed hydrocephalus compared to 32.5% of those at the untreated group. Fourteen(23.3%) patients in treated group developed symptomatic vasospasm and 6 of them(10%) suffered stroke whereas incidences of these in untreated group were 25.9% and 11.7%, respectively. The AMCA treated group showed more favorable outcome than that of untreated group. There was no case of death by rebleeding in the AMCA treated group while one of the main causes of death in the untreated group was rebleeding. Conclusion : Short-term high-dose AMCA administration is considered beneficial in improving outcome and diminishing the risk of rebleeding in the patients who suffer from an aneurysmal SAH prior to early surgical intervention.

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Traumatic Hemorrhage in Suprapatellar Bursa Complicated by Suprapatellar Plica with Complete Septum -A Case Report- (완전 격막형 슬개상 추벽에 의해 합병된 슬개상 점액낭 내 외상성 출혈 -1예 보고-)

  • Koh, Hae-Seok;In, Yong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.63-65
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    • 2008
  • We treated a 37-year-old male with traumatic hematoma in the suprapatellar bursa that had developed in the form of persistent swelling on suprapatellar area of left knee after blunt trauma. Though there were no obvious abnormal findings on plain roentgenographs, an isolated suprapatellar cystic lesion with fluid-fluid level on T2-weighted sagittal image of MRI was noted. We found the suprapatellar plica with complete septum and no synovitis in the knee joint proper by arthroscopy. We incised the plica and found leakage of blood-stained fluid from the suprapatellar bursa. There were no findings of pigmented villonodular synovitis or other tumorous lesions. At 6 months after surgery, the patient felt symptom-free and there was no recurrence.

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Usefulness of $^{99m}Tc$-HMPAO SPECT in Patients with Subarachnoid Hemorrhage due to Ruptured Intracranial Aneurysm (뇌동맥류파열에 의한 지주막하출혈 환자에서 $^{99m}Tc$-HMPAO SPECT 검사의 유용성)

  • Choi, C.W.;Lee, K.H.;Kim, J.H.;Kwark, C.;Lee, D.S.;Chung, J.K.;Lee, M.C.;Han, D.H.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.175-182
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    • 1993
  • We evaluated the usefulness of $^{99m}Tc$-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients (48%), but CT/MRI showed the bilateral abnormalities in only 3 patients (14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that $^{99m}Tc$-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

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Correlation of Changes of Intracranial Pressure and Clinical Manifestations in Spontaneous Intracerebral Hemorrhage (자발성 뇌실질내혈종 환자에서의 뇌압변화와 임상증상과의 관계)

  • Chung, Eul-Soo;Ko, Sam-Kyu;Kim, Oh-Lyong;Chi, Yung-Chul;Choi, Byung-Yearn;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.35-44
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    • 1991
  • Recently many authors have reported about the relationship of the volumes of hemorrhage in the brain parenchyme, hemorrhagic sites, optimal operation time, and the effects of mannitol and steroid on control of ICP to clinical manifestations. Many attempts to measue ICP in hydrocephalus, brain tumor, and head injury have been reported. But the measurements of intracranial pressure in spontaneous intracerebral hemorrhage are rare. Intracranial pressure was monitored prospectively in 30 patients who had stereotaxic surgery for spontaneous intracerebral hemorrhage. The results are as follows. 1. Intracranial pressure was increased in high $PaCO_2$. 2. There were no correlation in ICP, rebleeding and ADL at discharge(P > 0.05). 3. ICP was the most high level in 72 hours after operation. 4. There was 63.2% decrease in ICP after litigation with 6000 IU urokinase in the site of hemorrhage. 5. There was no correlation between the numbers of natural drainage and ADL at discharge(P > 0.05). 6. The higher the initial GCS, the higher the Postoperative GCS.

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