• Title/Summary/Keyword: 출혈 평가

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Convergence Effect of Simulation Training on Bleeding Amount Estimation in Trauma (시뮬레이션 교육이 외상성 출혈의 출혈량 추정에 미치는 융합적 영향)

  • Yang, Hyun-Mo;Kim, Gyoung-Yong
    • Journal of the Korea Convergence Society
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    • v.12 no.4
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    • pp.69-76
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    • 2021
  • The purpose of the study is to examine the visual evaluation of bleeding amount in hemorrhagic shock in paramedic students. Through manikin simulation training, paramedic students were able to have confidence with estimation of bleeding amount in the prehospital settings. Three rescue training manikins were placed in supine position and artificial blood was poured between the abdomen and pelvis. The bleeding evaluations of 700 mL, 1200 mL, and 1700 mL were performed before and after simulation training. Paramedic students underestimated the amount of bleeding in the trauma situation, and it was found that it was difficult for the students to evaluate the accurate amount of bleeding with a single simulation.

Hyperacute Intracerebral Hemorrhage : Comparison of EPI and Other MR Sequence (두 개내 초급성 출혈 : EPI와 다른 MR 영상 기법의 비교)

  • 김정희;김옥화;서정호;박용성
    • Investigative Magnetic Resonance Imaging
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    • v.3 no.2
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    • pp.167-172
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    • 1999
  • Purpose : To evaluate the detection rate of hyperacute intracerebral hemorrhage in echo planar imaging (EPI) and other MR sequences. materials and Methods : Intracerebral hemorrhage was experimentally induced in ten rats. EPI, fast spin-echo (FSE) T2 weighted images, fluid attenuated inversion recovery (FLAIR), spin-echo (SE) T1 weighted images and gradient echo (GE) T1 weight ed images of rat's brains were obtained 2 hours after onset of intracerebral hemorrhage. EPI and FSE T2 images were additionally obtained 30 min and 1 hour after onset of hemorrhage in 3 and 6 rat, repeatedly, For objective visual assessment, discrimination between the lesion and normal brain parenchyma was evaluated on various MR sequences by three radiologists. For quantitative assessment, contrast-to-noise ratio (CNR) was calculated fro hemorrhage-normal brain parenchyma. Statistical analysis was performed usning the Wilcoxon-Ranks test. Results : EPI, FLAIR, and FSE T2 images showed high signal intensity lesions. The lesion discrimination was easier on EPI than on other sequences, and also EPI showed higher signal intensity for the subjective visual assessment. In quantitative evaluation, CNR of the hemorrhagic lesion versus normal brain parenchyma were higher on EPI and FLAIR images (p<0.01). There was no difference in CNR between EPI and FLAIR (p>0.10). On MR images obtained 30 minutes and 1 hour after the onset of intracerebral hemorrhage, the lesion detection was feasible on both EPI and FSE T2 images showing high signal intensity. Conclusion : EPI showed higher detection rate as compared with other MR sequences and could be useful in early detection and evaluation of intracerebral hemorrhage.

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Predictive model and quantitative microbial risk assessment of enterohemorrhagic Escherichia coli and Campylobacter jejuni in milk (우유에서 장출혈성 대장균과 캠필로박터균의 행동예측 모델 개발 및 정량적 미생물 위해성 평가 연구)

  • Dong, Jiaming;Min, Kyung Jin;Seo, Kun Ho;Yoon, Ki Sun
    • Korean Journal of Food Science and Technology
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    • v.53 no.5
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    • pp.657-668
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    • 2021
  • We prepared the growth and survival models of enterohemorrhagic Escherichia coli (EHEC) and Campylobacter jejuni in milk as a function of temperature and assessed the microbiological risks associated with the consumption of whole milk. EHEC and C. jejuni were not detected in whole milk (n=195) in the retail market. The minimum growth temperature of EHEC in milk was 7℃. The lag time of EHEC in whole milk was longer than that in skim milk. The survival ability of C. jejuni in milk was better at 4℃ than at 10℃. Lower delta values were observed in whole milk than in skim milk, indicating that C. jejuni survived better in skim milk. The probability of foodborne illness from whole milk consumption was 5.70×10-5 for EHEC and 9.86×10-9 for C. jejuni. Sensitivity analysis results show that the market temperature of EHEC and the dose-response model of C. jejuni are correlated with the probability of foodborne illness.

Radiologic Diagnosis of Gastrointestinal Bleeding (위장관 출혈의 영상의학적 진단법)

  • Se Hyung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.520-535
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    • 2023
  • Gastrointestinal (GI) bleeding is not a single disease but a symptom and clinical manifestation of a broad spectrum of conditions in the GI tract. According to its clinical presentation, GI bleeding can be classified into overt, occult, and obscure types. Additionally, it can be divided into upper and lower GI bleeding based on the Treitz ligament. Variable disease entities, including vascular lesions, polyps, neoplasms, inflammation such as Crohn's disease, and heterotopic pancreatic or gastric tissue, can cause GI bleeding. CT and conventional angiographies and nuclear scintigraphy are all radiologic imaging modalities that can be used to evaluate overt bleeding. For the work-up of occult GI bleeding, CT enterography (CTE) can be the first imaging modality. For CTE, an adequate bowel distention is critical for obtaining acceptable diagnostic performance as well as minimizing false positives and negatives. Meckel's scintigraphy can be complementarily useful in cases where the diagnosis of CTE is suboptimal. For the evaluation of obscured GI bleeding, various imaging modalities can be used based on clinical status and providers' preferences.

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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The Effect of Splinting with Concomitant Root Planing;Clinical and Digital Subtraction Radiographic Study (치근활택술과 스프린트 병행처치의 효과에 관한 연구;디지털 공제 촬영술을 이용한 임상적 연구)

  • Lee, Ji-Young;Kye, Seung-Bum;Kim, Won-Kyoung;Lee, Yong-Moo;Ku, Young;Ryu, In-Chul;Chung, Chong-Pyoung;Choi, Sang-Mook;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.31 no.1
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    • pp.207-227
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    • 2001
  • 스프린트는 치주처지료에서 부가적 처치법으로 널리 사용되고 있으며, 한편, 디지털 공제 활영술은 기존방사선촬영술의 한계점을 극복하기 위해 기발된 새로운 방법이다. 이번 연구에서는 치근활택술 단독시행시와 스피린트 병행 처치시의 효과를 임상적, 방사선학적으로 비교하였다. 중정도의 성인성 치주염을 가진 20명의 환자를 대상으로 하되 10명은 치근활택술 단독으로, 나머지 10명은 스프린트 병행처치로 처치하였다. 임상적, 방사선학적인 평가는 처치전, 처치후 6개월에 행하고, 임상적 평가의 경우 3개월에 추가로 실시하였다. 이번 연구에서 사용된 임상 지수로는 치태지수, 치은지수, 치은퇴축, 치주낭깊이, 임상부착수준, 임상부착증가, 탐침시출혈, 치아동요도 등이며, 방사선학적 평가는 기존 방사선촬영술에 의한 방법과 디지털 공제촬영수렝 의한 방법으로 행하였다. 디지털 공제 촬영술에 의한 평가시, 영상은 Digora 프로그램에 의해 획득하고 Emago 프로그램으로 처리 하여 다음과 같은 결론을 얻었다. 1. 처치후 3개월에 치태지수, 치은지수, 치은퇴축, 치주낭깊이, 임상적부착수준, 탐침시 출혈 등의 임상지수들이 변했으며, 특히 이러한 변화는 치주낭깊이, 치은퇴축, 탐침시출혈에서 유의성이 있었다. ( p<0.05 ) 그러나 두군간 차이는 인정되지 않았다. ( p>0.05 ) 2. 처치후 6개월에도 치태지수, 치은지수, 치은퇴축, 치주낭깊이, 임상적부착수준, 탐침시출혈, 치아동요도 등의 임상지수들이 변했으며, 특히 이러한 변화는 치주낭깊이, 치은퇴축, 탐침시출혈, 치태지수, 치아동요도에서 유의성이 있었다. ( p<0.05 ) 그러나 두 군간 차이는 인정되지 않았다. ( p>0.05 ) 3. 켄달 상관분석시, 임상적 평가와 기존 방사선 촬영술에 의한 평가사이의 관련성을 낮았으며 거의 0에 가까운 수치를 보였으며 (r=0.110, p=0.639 ) 임상적 평가와 디지털 공제 방사선 촬영술에 의한 평가사이에서 약간 높은 관련성을 보였다. ( r=0.257, p=0.315 ) 즉 치주치료후의 골변화는 디지털 공제 방사선 촬영술에 의한 평가시 기존 방사선 사진보다 임상적 부착증가와 더욱 긴밀한 관련성을 보여준다. 이상의 결과로 볼 때, 스프린팅 처치는 치주 치료에 있어 치근활택술에 부가적 표과를 제공하지 못한다.

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Severe Hemorrhage Induced Expressions of Ferritin and Heme Oxygenase-1 In Leukocytes (출혈로 인한 폐 염증세포에서의 ferritin과 heme oxygenase-1의 발현)

  • Kwon, Jung-Wan;Park, Yoon-Yub
    • Journal of Life Science
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    • v.19 no.7
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    • pp.878-885
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    • 2009
  • Serum ferritin levels are elevated in subjects with acute lung injury (ALI), and abnormalities in plasma and lung iron chemistry have also been demonstrated in ALI and acute respiratory distress syndrome (ARDS). Stress-inducible heme oxygenase-1 (HO-1), as well as ferritin, had shown anti-inflammatory actions. Biomarkers for early detection in patients who are likely to develop ARDS would give several therapeutic chances to the patients. In order to verify the predictability in severe hemorrhage-induced ALI in rats, we measured serum ferritin and HO-1 concentrations before and after hemorrhage. Severe hemorrhages significantly increased the number of leukocytes in bronchoalveolar lavage (BAL) fluid and lung tissue myeloperoxidase activity. Both serum ferritin and HO-1 levels increased following hemorrhage, but ferritin levels were elevated earlier than HO-1. In BAL cell immunohistochemical studies, ferritin and HO-1 expressions increased after hemorrhage and localized in the cytoplasm of leukocytes. These findings suggest that inflammatory leukocytes in BAL fluid can secrete ferritin and HO-1, and serum ferritin levels might be more valid factor in predicting ARDS than HO-1 levels in hemorrhage-induced ALI.

Recovery and Associated Factors of Cognitive Function in Patients with Hemorrhagic Stroke (출혈성 뇌졸중 환자의 인지기능 변화 및 연관 요인에 대한 추적조사)

  • Park, Minsu;Min, Ji Hong;Ko, Sung Hwa;Lee, Sang Won;Ko, Hyun-Yoon;Shin, Yong-Il
    • 재활복지
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    • v.21 no.2
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    • pp.247-259
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    • 2017
  • We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.

Penetrating Injuries by Foreign Body in the Head and Neck Region (두경부의 이물질 삽입에 의한 관통성 외상)

  • Hong, Soon-Xae;Baek, Ji-Young;Cha, In-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.351-355
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    • 2000
  • Penetrating injuries in the head and neck region are not common but can pose difficult situations to manage properly. In small cross-sectional area, the neck housed many vital structures, such as carotid artery, internal jugular vein, cervical spines, esophagus, laryngotracheal complex and nerves. Because each vital structure is located within the fascial compartments, bleeding into these closed spaces can give rise to compression of surrounding structures, which may result in compromised airway. Therefore, management of the penetrating injuries should be based on the fully understanding of anatomical relationships, accurate clinical examinations, a careful history taking and the proper treatment planning. We present two cases of penetrating injuries in the head and neck region and discuss on the clinical considerations for the proper management with the literature review.

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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.