• Title/Summary/Keyword: 재출혈

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A Study on the Protective Effect of Antioxidants on Damage Induced by Liver Ischemia/Repefusion in a Rat Model (모델 랫드에 간 허혈/재관류로 유발된 손상에 대한 항산화제의 보호 효과에 관한 연구)

  • Ahn, Yong Ho;Seok, Pu Reum;Oh, Su Jin;Choi, Jin Woo;Shin, Jae-Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.3
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    • pp.370-378
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    • 2019
  • The hepatic ischemic model has recently been widely used for the epidemiological study of ischemic reperfusion injury. This study was carried out to investigate the protective effect of vanillin, which is known to have antioxidant and anti-inflammatory effects, against hepatic and renal injury using an ischemia-reperfusion rat model, and we also investigated the mechanism related to vanillins' protective effect. The test material was administered at a concentration of 100 mg/kg for 3 days, followed by ligation of the liver for 60 minutes to induce ischemia reperfusion. As control groups, there was a negative control, sham control and ischemia-reperfusion-only ischemia reperfusion control, and the controls groups were compared with the drug administration group. In the vanillin group, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were significantly inhibited compared with the AST and ALT activities of the ischemia-reperfusion group, and histopathological examination showed significant reduction of both inflammation and necrosis. The malondialdehyde (MDA) and superoxide dismutase (SOD) levels were significantly different from the ischemia-reperfusion group. In conclusion, vanillin showed a hepatocyte protective action by alleviating the cellular inflammation and cell necrosis caused by hepatic ischemia-reperfusion, and vanillin mitigated inflammatory changes in the kidney glomeruli and distal tubules. The protective effect is considered to be caused by vanillin's antioxidant function. Further studies such as on cell death and possibly vanillin's same effect on damaged tissue will be necessary for clinical applications such as organ transplantation.

Factor affecting Unplanned Readmissions after Cardiac Valve Surgery: Analysis of Electric Medical Record (심장판막수술 환자의 비계획적 재입원 영향요인: 전자의무기록분석)

  • Lee, Jung Sun;Shin, Yong Soon
    • The Journal of the Korea Contents Association
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    • v.22 no.2
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    • pp.794-802
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    • 2022
  • This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.

Treatment of giant iatrogenic pseudoaneurysm of the femoral artery (대퇴동맥에 발생한 의인성 거대 가성동맥류에 대한 치료)

  • Kang, Wu-Seong;Park, Chan-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.423-428
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    • 2019
  • The role of angioembolization has increased because of increases in nonoperative treatment for traumatic splenic injury. We report here a case of successful treatment of iatrogenic pseudoaneurysm of the femoral artery by thrombin injection with coil embolization. A 55-year-old female was admitted to our hospital because of blunt trauma. Computed tomography (CT) revealed a grade V splenic injury with contrast extravasation; therefore, angioembolization was performed. Three days after admission, follow-up CT scan revealed rebleeding from the spleen, and repeat angioembolization was performed. Seven days after admission, an approximately $7.0cm{\times}4.0cm-sized$ pseudoaneurysm was found on follow-up CT scan and there was no bleeding from the spleen. Although thrombin was injected into the aneurysmal sac, there was still inflow of blood, as observed on color-doppler ultrasound. Therefore, coil embolization to the neck of the aneurysm was performed. On angiography, there was no contrast filling into the sac. The size of the pseudoaneurysmal sac had decreased on follow-up CT scan, and the patient was discharged to home without complications. We successfully treated a giant pseudoaneurysm of the femoral artery using thrombin and coil embolization.

Ubiquitous in Corrugating Factory (골판지제조공장의 새로운 패러다임(1))

  • 전재영
    • Corrugated packaging logistics
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    • no.62
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    • pp.55-64
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    • 2005
  • 1856년 7월7일 영국에서 에드워드 찰스 힐리 와 에드워드 엘리스 알렌(Edward Charles Healey & Edward Ellis Allen)에 의해 골판지가 처음 발명되었고, 15년후인 1871년12월19일에 현재의 골판지상자 형태의 특허가 미국의 알버트. L. 존스(Albert. L.Jones)에게 취득된지 130여년이상이 지난 이 시대에는 실로 다양한 분야에서 골판지를 사용하고 있지만, 주 사용분야는 포장산업의 분야이다. 과거에는 포장의 주목적은 첫째 포장 내용물(상품)의 보호 둘째 상품의 운송과 적재 및 취급의 편리성 셋째 상품 구매동기 유발의 순서이었으나 최근에는 첫째와 둘째의 목적은 필수불가결한 것이고 세번째의 상품 구매동기 유발의 목적에 더 큰 비중이 있는 추세이다. 따라서 포장재의 규격은 생산자의 입장에서는 보다 단순해지고 규격화 되는 것이 생산코스트의 절감과 생산성향상의 지름길이지만(그러나 더욱 복잡해지고 비규격화 되는 것이 제품 부가가치가 더 높을 수도 있기 때문에 여기에는 보다 신중한 판단이 필요하다.) 각종 통신기술, 인터넷과 I.T산업의 발달과 더불어 소비자가 언제라도 상품의 다양한 정보에 쉽게 접할 수있는 이 시대에는 다양한 소비계층의 NEED를 모두 만족시켜 줄려고 하는 상품 개발자의 제품설계 및 개발과 판매전략에 의해 더욱 더 상품은 다양해지고 있다.(필자의 판단으로는 앞으로 보다 더 다양해지고 복잡해지고 있는 추세이다.) 즉 다시말하면 이러한 다양한 형태의 포장재의 변화를 수용하여, 가장 높은 가격경쟁력으로, 적시에 가장빠르게 생산하여 공급할 수있는 능력을 갖춘 포장재 제조업자만이 미래에는 적자생존 할 수있다는 결론이다. 더욱이 우리나라의 현실은 대한민국 골판지 포장산업의 특성상 세계적으로 유래가 없는 적은 판매마진(과도한 출혈경쟁으로 인함)으로 인하여, 생산설비만 계속 증설하여 생산량과 규모에 의한 경제성 만으로 수치채산성을 맞추는 형태로 발전하여 왔기 때문에, 각 골판지 생산공장의 수익성은 악화일로로 치닫고 있는 실정이다. 즉 아주 적은 규모의 공장이나 아니면 많은 자금력을 이용한 대형공장만이 수익성을 유지하고 있는 것처럼 보인다.(지금과 같이 시장의 성장이 없는 골판지시징에서 시장의 총규모는 정해진 상태이고, 여기에서 서로 나눠 가지는 형태이므로, 최악의 경우는 어느 한쪽만이 살아 남는 제로섬 게임이 될 수 있으므로, 실제로는 가장 적정한 규모의 공장이 가장수익성이 높다.) 여기에서 필자는 이러한 위기에 처해 있는 우리나라 골판지산업의 생산공장에서 생산성을 저하시켜 제조원가를 높이는 요인들을 살펴보고, 이 요인들 중에서 주된 요인중의 하나인 소로트오다가 더욱 더 많아지고 있는 현실과 다가오는 미래의 상황에 대비해 골판지 공장의 완전자동화(Ubiquitous in Corrugating Factory)에 대비한 가장 효율적인 소로트생산 운영방법에 대해서 집중적으로 이야기 해보고자 한다.

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A Study on the Factors that Influence the Surgical Outcomes of Choledochal Cyst in Children (소아에서 담관 낭종의 수술 성적에 영향을 주는 요인에 대한 연구)

  • Kim, Jong-Kyu;Noh, Gyoung Tae;Min, Seok-Ki;Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.18 no.1
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    • pp.1-11
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    • 2012
  • 담관 낭종은 흔하지는 않지만, 외과적 절제가 필요한 주요 질환이다. 절제하지 않고 남겨두면 다른 질환으로의 이환이나 다양한 합병증에 의한 사망까지도 야기할 수 있기 때문에 적절한 수술적 치료가 필수적이다. 최근 수술에 따른 다양한 문제들이 계속 보고되고 있으며, 출생 전이나 건강 검진 시 발견되는 무증상의 담관 낭종의 수술 시기에 대해서도 아직 논란이 되고 있다. 저자들은 1995년부터 2009년까지 담관 낭종으로 수술 받은 환자 중 수술 받을 당시의 연령이 18세 이하인 32명 환자의 임상 양상과 수술 기록을 후향적으로 분석하여, 수술 성적에 영향을 주는 요인들을 알아보고자 하였다. 전체 32명 중 남자 10명, 여자 22명이었으며, 수술 당시의 평균 연령은 5.4세였다. 췌담관 합류이상은 9명(28.1%)이었으며, 평균 추적 관찰 기간은 34.6개월이었다. 술 전 증상을 호소한 환자는 30명(93.8%)이었으며, 복통(63.3%), 황달(40.0%), 구토(23.3%), 복부종물(16.7%), 발열(16.7%)등의 순서였다. 술 전 혈액 검사에서 AST/ALT의 상승이 18명(56.3%), 고빌리루빈혈증이 8명, 백혈구 증가증이 7명(21.9%)이었다. 술 후 합병증은 5명(15.6%)에서 나타났는데, 2명은 담관염이었고, 나머지 3명은 문합부 협착, 술 후 출혈, 장 폐쇄가 각각 1명 있었다. 술 후 평균 재원 기간은 12.2일 이었으며, 추적 관찰 기간 중 3명(9.0%)이 재입원 하였다. 수술 성적에 영향을 미치는 요인으로, 수술 당시의 나이가 많을수록 평균 수술 시간과 재원 기간이 증가하였다(p=0.004, p=0.028). 증상이 있었던 환자군에서 무증상 환자군보다 재원 기간이 더 길었다(p=0.001). 또한 췌담관 합류이상이 있었던 환자군에서 재입원율이 유의하게 높았다(p=0.005). 소아의 담관 낭종은 진단이 되면 증상 발현 전이라도 조기에 수술하는 것이 수술 시간 및 재원 기간을 단축시킬 수 있으며, 췌담관 합류이상이 동반된 경우에는 술 후에 재입원할 가능성이 높으므로 주의깊게 추적 관찰하는 것이 바람직할 것이다.

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Success and survival rate of the implant with crestal sinus lift using S-reamer and gel-type graft material: A retrospective study by more 5-years follow check up (S-reamer와 겔 형태의 이식재를 이용한 치조정 접근법을 통한 상악동 거상술 임플란트의 성공률과 생존율: 5년 이상 추적 관찰을 통한 후향적 연구)

  • Kim, Jong Jin;Cho, Sung Am
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.1
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    • pp.23-29
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    • 2020
  • Purpose: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate. Materials and methods: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 - 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed. Results: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%. Conclusion: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

Interventional radiology of Bronchial artery embolization due to massive hemoptysis (대량객혈로 인한 기관지 동맥 색전의 중재적 방사선시술)

  • Min, Byoung-Yun;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.4 no.4
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    • pp.17-24
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    • 2010
  • Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.

Tricuspid Replacement through Right Thoracotomy in Reoperation - A case report - (재수술 시 우측 개흉을 통한 삼첨판막 치환술 -1예 보고)

  • Kim Hyuck;Han San Woong;Chung Won Sang;Kang Jung Ho;Chon Soon Ho;Lee Chul Bum;Kim Young Hak
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.714-716
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    • 2005
  • In an extremely enlarged right heart, the repeated midline sternotomy was considered to involve the risk of massive hemorrhage. A right thoracotomy provides a convenient and safe way to approach the tricuspid valve in patient who have had previous heart surgery through a midline sternotomy.

Inflammatory Reponse of the Lung to Hypothermia and Fluid Therapy after Hemorrhagic Shock in Rats (흰쥐에서 출혈성 쇼크 후 회복 시 저체온법 및 수액 치료에 따른 폐장의 염증성 변화)

  • Jang, Won-Chae;Beom, Min-Sun;Jeong, In-Seok;Hong, Young-Ju;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.879-890
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    • 2006
  • Background: The dysfunction of multiple organs is found to be caused by reactive oxygen species as a major modulator of microvascular injury after hemorrhagic shock. Hemorrhagic shock, one of many causes inducing acute lung injury, is associated with increase in alveolocapillary permeability and characterized by edema, neutrophil infiltration, and hemorrhage in the interstitial and alveolar space. Aggressive and rapid fluid resuscitation potentially might increased the risk of pulmonary dysfunction by the interstitial edema. Therefore, in order to improve the pulmonary dysfunction induced by hemorrhagic shock, the present study was attempted to investigate how to reduce the inflammatory responses and edema in lung. Material and Method: Male Sprague-Dawley rats, weight 300 to 350 gm were anesthetized with ketamine(7 mg/kg) intramuscular Hemorrhagic Shock(HS) was induced by withdrawal of 3 mL/100 g over 10 min. through right jugular vein. Mean arterial pressure was then maintained at $35{\sim}40$ mmHg by further blood withdrawal. At 60 min. after HS, the shed blood and Ringer's solution or 5% albumin was infused to restore mean carotid arterial pressure over 80 mmHg. Rats were divided into three groups according to rectal temperature level($37^{\circ}C$[normothermia] vs $33^{\circ}C$[mild hypothermia]) and resuscitation fluid(lactate Ringer's solution vs 5% albumin solution). Group I consisted of rats with the normothermia and lactate Ringer's solution infusion. Group II consisted of rats with the systemic hypothermia and lactate Ringer's solution infusion. Group III consisted of rats with the systemic hypothermia and 5% albumin solution infusion. Hemodynamic parameters(heart rate, mean carotid arterial pressure), metabolism, and pulmonary tissue damage were observed for 4 hours. Result: In all experimental groups including 6 rats in group I, totally 26 rats were alive in 3rd stage. However, bleeding volume of group I in first stage was $3.2{\pm}0.5$ mL/100 g less than those of group II($3.9{\pm}0.8$ mL/100 g) and group III($4.1{\pm}0.7$ mL/100 g). Fluid volume infused in 2nd stage was $28.6{\pm}6.0$ mL(group I), $20.6{\pm}4.0$ mL(group II) and $14.7{\pm}2.7$ mL(group III), retrospectively in which there was statistically a significance between all groups(p<0.05). Plasma potassium level was markedly elevated in comparison with other groups(II and III), whereas glucose level was obviously reduced in 2nd stage of group I. Level of interleukine-8 in group I was obviously higher than that of group II or III(p<0.05). They were $1.834{\pm}437$ pg/mL(group I), $1,006{\pm}532$ pg/mL(group II), and $764{\pm}302$ pg/mL(group III), retrospectively. In histologic score, the score of group III($1.6{\pm}0.6$) was significantly lower than that of group I($2.8{\pm}1.2$)(p<0.05). Conclusion: In pressure-controlled hemorrhagic shock model, it is suggested that hypothermia might inhibit the direct damage of ischemic tissue through reduction of basic metabolic rate in shock state compared to normothermia. It seems that hypothermia should be benefit to recovery pulmonary function by reducing replaced fluid volume, inhibiting anti-inflammatory agent(IL-8) and leukocyte infiltration in state of ischemia-reperfusion injury. However, if is considered that other changes in pulmonary damage and inflammatory responses might induce by not only kinds of fluid solutions but also hypothermia, and that the detailed evaluation should be study.

The Scope of Regenerative Endodontics on Open-Apices in Young Permanent Teeth (영구치의 개방성 치근첨에 대한 재생 근관치료적 의견)

  • Cho, Yongbum
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.197-202
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    • 2015
  • Numerous challenges in treating permanent dentition are encountered, especially in treating immature teeth with pulp necrosis. Historically, calcium hydroxide application during long periods of time was used to induce the formation of a calcific barrier across the open apex. In 2004, a new treatment modality for the management of the open apex was introduced. This treatment was named as 'revascularization' and gained acceptance among dentists. The protocol was different from the traditional apexification techniques in that the canal was irrigated and disinfected with a combination of three antibiotics (ciprofloxacin, metronidazole and minocycline). At the next appointment, bleeding was induced and the canal was sealed with MTA. Successful regenerative endodontic treatment of necrotic immature permanent teeth can provide continued root development, increased thickness in the dentinal walls and apical closure. These developments of a functional pulp-dentin complex have a promising impact on retaining the natural teeth, the goal of the dental health care.