• Title/Summary/Keyword: 출혈경향성

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The Influences of Perfusion Temperature on Inflammatory and Hematologic Responses during Cardiopulmonary Bypass (체외순환시 염증과 혈액학적 반응에 대한 관류온도의 영향)

  • 김상필;최석철;박동욱;한일용;이양행;조광현;황윤호
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.817-826
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    • 2004
  • Background: Several studies have demonstrated that conventional hypothermic cardiopulmonary bypass (CPB) causes cellular injury, abnormal responses in peripheral vascular beds and increased postoperative bleeding, whereas normothermic CPB provides protection of the hypothermic-induced effects and better cardiac recovery. The present study was prospectively performed to compare the effects of normothermic CPB to those of hypothermic CPB on the inflammatory and hematologic responses during cardiac surgery. Material and Method: Thirty-four adult patients scheduled for elective cardiac surgery were randomly assigned to hypothermic CPB (nasopharyngeal temperature $26~28^{\circ}C,$ n=17) or normothermic CPB (nasopharyngeal $temperature>35.5^{\circ}C,$ n=17) group. In both groups, cold $(4^{\circ}C)$ crystalloid cardioplegia was applied for myocardial protection. Blood samples were drawn from radial artery before (Pre-CPB), 10 minutes after starting (CPB-10) and immediately after ending (CPB-OFF) CPB. Total leukocyte and platelet counts, interleukin-6 (IL-6) level(expressed as percent to the baseline of Pre-CPB), D-dimer level, protein C and protein S activity were measured with the blood samples. The amount of bleeding for postoperative 24 hours and blood transfusion after operation were also assessed. All parameters were compared between the two groups. Result: The total leukocyte counts $(10,032\pm65/mm^3)$ and the increased ratio of IL-6 $(353\pm7.0%)$ at CPB-OFF in the normothermic group were higher than that $(7,254\pm48/mm^3$ and $298\pm7.3%)$ of the hypothermic group(p=0.02 and p=0.03). In the normothermic group, protein C activity $(32\pm3.8%)$ and protein S activity $(35\pm4.1%)$ at CPB-OFF were significantly lower than that $(45\pm4.3%$ and $51\pm3.8%)$ of the hypothermic group (p=0.04 and p=0.009). However, there were no differences in platelet counts and D-dimer concentration. In the normothermic group, the amount of bleeding for postoperative 24 hours $(850\pm23.2$ mL) and requirements for blood transfusion after operation such as packed cell $(1,402\pm20.5$ mL), fresh frozen plasma $(970\pm20.8$ mL) and platelet $(252\pm6.4$ mL) were higher than that $(530\pm21.5$ mL, $696\pm15.7$ mL, $603\pm18.2$ mL and $50\pm0.0$ mL) of the hypothermic group. Conclusion: These results indicate that normothermic CPB with cold crystalloid cardioplegia was associated with higher increase in inflammatory response, hemostatic abnormalities and postoperative bleeding problem than moderate hypothermic CPB.

Effect of Prophylactic Ibuprofen in Preterm Infants Less than 1,250 g in Birth Weight (1,250 g 미만 미숙아에서 예방적 Ibuprofen의 효과)

  • Yeo, Mun-Soo;Choi, Kyung-Vin;Lee, Hyun-Ju;Park, Hyun-Kyung;Kim, Chang-Ryul;Seol, In-Joon
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.234-239
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    • 2011
  • Purpose: Ibuprofen is used for prevention and treatment of patent ductus arteriosus as an alternative drug of indomethacin in very premature infants. We aimed to determine the effect of prophylactic ibuprofen on patent ductus arteriosus and clinical outcomes in preterm infants less than 1,250 g. Methods: A retrospective review of 39 preterm infants who were admitted to our neonatal intensive care unit from November 2009 to July 2010 was performed. Patients were divided into a prophylactic group (n=13) and a matched historical control group (n=26), where prophylactic ibuprofen were administrated within 24 hours after birth. The rate of ductal closure, side-effects of drug treatment and clinical outcomes were compared between two groups. Results: Comparison of the prophylactic and control groups revealed no significant differences in the rate of ductal closure (69.2% vs 77.7%, P=0.825) and surgical ligation (23.1% vs 30.8%, P=0.719). Occurrence of bowel perforation was more frequent in the prophylactic group than the control group, but was not significant (30.8% vs 11.5%, P=0.194). The frequency of intraventricular hemorrhage (grade${\geq}$3) and other outcomes did not differ between the groups. Conclusion: Ibuprofen prophylaxis in preterm infants did not decrease the rate of ductal closure, the need for surgical ligation and the incidence of intraventricular hemorrhage. Further studies are needed to investigate the beneficial effect and associated adverse events attributed to ibuprofen prophylaxis.

The Protective Effects of Kamdootang on Accumulation of Cadmium in Rats (랫트의 신장 내 카드뮴 축적에 대한 감두탕(甘豆湯)의 방어 효과)

  • Kim, Pom-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.5
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    • pp.2180-2186
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    • 2011
  • To find out the protective effects of Kamdootang against accumulation of cadmium in rats, the experimental rats were divided into 2 groups. One group was administered with cadmium alone and the other group administered with cadmium mixed with Kamdootang. Each group has been orally administered with different doses of cadmium such as 1.7 ${\mu}g/g/day$, 3.4 ${\mu}g/g/day$ and 6.8 ${\mu}g/g/day$, respectively, for 1 to 8 weeks. As a results, body weight gained has a tendency to decrease more in the Kamdootang treated groups and non-treated groups than in control group. Cadmium accumulation in kidney showed a significant difference between the Kamdootang treated group and Kamdootang non-treated group. As the experiment period is longer and longer, both groups have got more significantly cadmium accumulation amounts. The kidney system was researched through histopathological observation that Multiple foci of necrosis, hemorrhagic necrosis in glomeruli and cloudy swelling of tubules in kamdootang non-treated group. but tissue lesion of kidney was showed less kamdootang treated group than Kamdootang non-treated group. As remarked above results, when dose low concentrated Cd in rat, Kamdootang was reduced accumulation of Cd. in kidney.

Effect of Pinus densiflora Extract on Blood Glucose Level, OGTT and Biochemical Parameters in Streptozotocin Induced Diabetic Rats (솔잎증류액의 투여가 Streptozotocin으로 유도한 당뇨쥐에서 혈당, 구강내당능검사, 혈액 성분에 미치는 영향)

  • Kim, Shin-Hee;Hwang, Seock-Yeon;Park, Oh-Sung;Kim, Moo-Kang;Chung, Young-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.7
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    • pp.973-979
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    • 2005
  • To investigate the effect of Pinus densiflora on biochemical parameters in type I diabetic rats, we evaluated the changes of body weight, fasting blood glucose level, oral glucose tolerance test (OGTT) and biochemical parameters after the intraperitoneal injection of distilled solution of Pinus densiflora in streptozotocin (STZ)­induced rats. Thirty-seven male Sprague Dawley rats $(180\pm10g)$ were divided into four groups; diabetic mellitus (DM) group received STZ (50 mg/kg BW, i.v.); low level of pine extract (LP) group received Pinus densiflora (5 mg/kg BW, i.p.), high level of pine extract (HP) group received Pinus densiflora (10 mg/kg BW, i.p.) after the single injection of STZ (50 mg/kg BW, i.v.), respectively. Normal control (NC) group received saline. The change of fasting blood glucose level and OGTT were measured using glucocard II, and the change of biochemical parameter were measured by Automatic Chemistry Analyzer (Hitach-747, Japan). Mean body weight change of DM group was retarded greatly by STZ-exposure. While, body weights of LP and HP groups were progressively increased with some fluctuation, although the increase rates were slower than that of NC group. Fasting blood glucose levels of LP and HP groups were reduced by Pinus densiflora injection, although the fasting blood glucose levels were higher than that of NC group. The results of OGTT was significantly improved in both of LP and HP group compared to DM group. Increases of blood glucose, alanine aminotransferase (ALT), alkaline phosphatase (ALP) and blood urea nitrogen (BUN) levels by STZ-exposure were attenuated by the Pinus densiflora treatment (p<0.05). From the results, it was suggested that Pinus densiflora has a tendency to decrease STZ-induced toxicity in terms of monitoring fasting blood glucose, OGTT and some biochemical parameters of rat.

Estimation of infection distribution and prevalence number of Tsutsugamushi fever in Korea (국내 쯔쯔가무시증의 감염자 분포와 유병자수 추정)

  • Lee, Jung-Hee;Murshed, Sharwar;Park, Jeong-Soo
    • Journal of the Korean Data and Information Science Society
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    • v.20 no.1
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    • pp.149-158
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    • 2009
  • Tsutsugamushi fever occupies more than 80% of total fall epidemic diseases and has an incubation period of 1 or 2 weeks as well. We have assumed that the incubation period distribution is gamma and therefore, reach an agreement that the infected distribution is normal with ${\hat{\mu}}=309.92$, ${\hat{\sigma}}=14.154$ by back calculation method. The infection cases are found severely large around the month of October. The infection case distribution demonstrates the incidence number increasing rapidly and progresses fast during the month of November. In this study, we have calculated the future prevalence number of maximum 1,200 people by inferred infection probability and incubation period distribution with some sort of limitation that the trend of increasing incidence number is not taking into an account. We considered the SIRS model which is also known as epidemic model, familiar to interaction between epidemiological classes. Our estimated parameters converged well with the initial parameter values.

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A Pediatric Case of Dengue Fever with Extreme Hyperglycemia Developed in a Family Who Returned from India (인도에서 귀국한 가족에서 발생한 심한 고혈당 동반 소아 뎅기열 1례)

  • Kim, Joon Young;Kim, Han Wool
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.140-146
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    • 2020
  • Dengue fever (DF) is endemic throughout tropical and subtropical regions; however, it is not endemic in Korea. Imported infectious diseases should be suspected when encountering returned travelers with non-specific symptoms such as fever, rash, and headache. Persistent vomiting, abdominal pain, hemorrhagic tendency, hepatic enzyme abnormalities, and proteinuria are risk factors for the development of severe DF in a patient with DF. Severe hyperglycemia is also known to be related to poor prognosis in acute illness, and with certain underlying diseases that present with hyperglycemia, such as diabetes, it is related to the progression of severe DF. We report a DF case with severe hyperglycemia in an adolescent returning from India. Pediatric DF cases reported in Korea were also reviewed.

Hereditary Tyrosinemia Type I (Hereditary Tyrosinemia Type I 환아의 NTBC 치료 경험)

  • Kang, Hyun-Young;Kim, Sook Za;Song, Wung Joo;Chang, Mi-Young
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.4 no.1
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    • pp.13-17
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    • 2004
  • Hereditary tyrosinemia type I (fiunarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that results in liver failure in infancy or chronic liver disease with cirrhosis, frequently complicated by hepatocellular carcinoma in childhood or early adolescence. Early detection of this condition is very important to early intervention for better prognosis of patients. Neonatal screening test using tandem mass spectrometry (MS-MS) is performed, and this method facilitates detection of the inborn error of tyrosine. For early treatment of tyrosinemia type I, phenylalanine and tyrosine restricted diet and NTBC (2-nitro-4-trifluoromethylbenzoyl-1,3-cyclohexanedione) for inhibition of succinylacetone production are recommended. We studied a 10-month-old Korean boy with tyrosinemia type I whose condition was not discovered earlier through conventional neonatal screening testing available in Korea. The patient presented hyperbilirubinemia, liver failure, bleeding tendency, colicky pain and skin melanin pigmentation in neonatal period. MS-MS made it possible to detect tyrosinemia type I and allowed immediate treatment of the patient. This was the first successful NTBC trial on tyrosinemia type I patient in Korea.

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A Rare Case of Acute Pyelonephritis Leading to Bilateral Subcapsular Renal Hematoma: A Case Report (급성 신우신염에 의한 양측 신피막하혈종 1예)

  • Hae Won Park;Minsuk Seo;Chung Sik Lee
    • The Korean Journal of Medicine
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    • v.99 no.3
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    • pp.158-163
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    • 2024
  • This case underscores the rarity of bilateral subcapsular renal hematoma (SCH) as a complication of acute pyelonephritis, and this is the first reported case in South Korea. SCH can have various underlying causes, including cysts, bleeding tendencies, cancer, vascular diseases and, less commonly, infections. A patient with uncontrolled diabetes mellitus and alcohol dependency presented with weakness. Bilateral SCH from acute pyelonephritis was diagnosed and treated with antibiotics and renal replacement therapy. Despite improved renal function, 30-day bilateral percutaneous drainage was necessary due to a persistent fever and elevated infection markers, resulting in a bloody, pus-like discharge. This case report sheds light on the rare etiology of bilateral SCH as a result of acute pyelonephritis. It serves as a reminder of the critical importance of timely intervention, to prevent deteriorating outcomes.

Effect of the Feeding Belly Fat on Plasma Lipids Levels in Rats (삼겹살기름의 섭취가 흰쥐의 혈액지질 수준에 미치는 영향)

  • 박병성
    • Food Science of Animal Resources
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    • v.24 no.2
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    • pp.189-197
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    • 2004
  • This study investigated the effect of belly fat on the plasma lipid concentrations in rats. The results were obtained from the rats that had been fed the experimental purified diets containing 5% corn oil (C) as the control, 5% commercial lard (Tl), 5% belly fat (T2), 10% belly fat(T3), and those given diet(T4) by feeding either C or T3 alternately every 3 days for 30 days. The food intake and food efficiency were not show any significant difference among the treatments. The body weight gain tended to significantly increased when the feeding of added-belly fat in diets (p<0.05). The plasma triacylglycerides of T3 was higher than the other treatments, and significantly elevated as the number of feeding days of the diets with the belly fat passed when compared to diet C (p<0.05). The plasma total cholesterol of T3 showed the highest levels in the treatment groups, and was high in the order of T1, T2, T4, and there was a significant difference between the rats given the diet with belly fat and C (p<0.05). The plasma HDL-C of T2 and T3 was showed the lowest levels in the treatment groups. The plasma HDL-C of T1, T2, T3 and T4 groups were significantly decreased as the number of feeding days of the diets with the belly fat increased when compared to diet C (p<0.05). The plasma LDL-C and Al of T3 showed the highest levels in the treatment groups, and the levels were in order of T1, T2, T4. There was a significant difference between the groups of rats given the belly fat and C (p<0.05). The bleeding times significantly decreased as the number of feeding days of the belly fat diets increased, and T3 showed the lowest levels, there was a significant difference among the treatment groups (p<0.05). The whole blood clotting times of T3 showed the lowest values, and significantly decreased according to the number of days of the rats were fed the belly fat diet (p<0.05). These results showed that frequent consumption and high intake of pork belly can elevate the plasma triacylglyceride and cholesterol levels, and also accelerate red thrombus formation because belly fat contains high levels of saturated fatty acids and cholesterol.

A study on the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis (알레르기성 직결장염의 임상상과 내시경 및 조직소견)

  • Lee, Joo Hee;Kim, Sung Shin;Park, Jae Ock
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.276-285
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    • 2008
  • Purpose : Allergic proctocolitis is a major cause of bloody stool in early infancy. This study was aimed at ascertaining the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis. We also analyzed the relationship between peripheral eosinophilia, the age at symptom onset, and sigmoidoscopic and histologic findings. Methods : We reviewed 25 infants retrospectively who had sigmoidoscopy and biopsy performed with a clinical diagnosis of allergic proctocolitis from April 2003 to April 2007. Results : The mean age at symptom onset was $15.2{\pm}13.2$ weeks. Fourteen infants (56.0%) were breast fed, one (4.0%) was formula fed, six (24.0%) were on combined formula, and four (16.0%) were on a weaning diet. Peripheral eosinophilia (${\geq}250/mm^3$) was seen in eighteen infants (75.0%), but total serum IgE was increased only in six (24.0%). Sigmoidoscopic findings were variable from normal (8.0%), erythema or edema (20.0%), lymphoid hyperplasia (8.0%), erosion (12.0%), hemorrhage and ulcer (4.0%) to lymphoid hyperplasia with erosion, hemorrhage, or ulcer (48.0%). Histologic findings showed focal infiltration of eosinophils in lamina propria (96.0%) and crypt epithelium (96.0%). In twenty four infants (96.0%), the number of eosinophils in mucosa was increased by a more than 60/10 high power field. There was a negative correlation between peripheral eosinophilia and the age at symptom onset. Among the twelve breast fed infants, bloody stool disappeared in ten (83.0%) with a maternal elimination diet of major food groups, but two improved spontaneously. Conclusion : Allergic proctocolitis should be considered as one of the major causes of bloody stool in healthy appearing infants. To confirm the diagnosis it is necessary to perform sigmoidoscopy and biopsy but histologic findings are more informative than sigmoidoscopic findings. Peripheral eosinophilia was prominent in the infants with an early onset of symptoms. Most infants experienced benign courses and recovered with the elimination of causative foods but did not need exclusive food restrictions.