• 제목/요약/키워드: Active bleeding

검색결과 110건 처리시간 0.024초

중증 간경변증 환자에서 발치창 과도 출혈부의 지속적 배농술을 통한 지혈 : 증례보고 (BLEEDING CONTROL BY CONTINUOUS WOUND DRAINAGE OF ACTIVE BLEEDING SITES OF TEETH EXTRACTION WOUND IN A PATIENT WITH ADVANCED LIVER CIRRHOSIS : REPORT OF A CASE)

  • 모동엽;유재하;최병호;김하랑;이천의;유미현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권6호
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    • pp.431-436
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    • 2009
  • There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

항응고제 투여중인 다발성 전신질환자에서 과도한 발치창 출혈부의 진정요법과 국소마취 시행하에 창상주위 봉합과 배농술 통한 출혈과 감염조절 (Bleeding & Infection Control by the Circumferential Suture & Drainage on Active Bleeding Extraction Socket under Sedation And Local Anesthesia in a Multiple Medically Compromised Patient with Anticoagulation Drug)

  • 유재하;김종배
    • 대한치과마취과학회지
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    • 제11권2호
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    • pp.177-182
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    • 2011
  • There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

객혈에서 굴곡성 기관지경의 출혈부위 결정을 위한 적절한 시행시기 및 그 유용성 (Optimal Time to Localize Bleeding Focus and the Usefulness of Flexible Bronchoscopy in Hemoptysis)

  • 이재호;고원중;이찬주;정희순
    • Tuberculosis and Respiratory Diseases
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    • 제49권3호
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    • pp.353-364
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    • 2000
  • 연구배경 : 객혈은 임상에서 흔한 증상의 하나인데, 기관지경검사는 객혈에서 진단이나 출혈부위와 확인, 그리고 치료에서 유용하게 사용된다. 그러나 기관지경검사의 적절한 시행시기 및 적응증에 대해서는 논란이 있다. 방법 : 객혈에서 기관지경검사의 적절한 시행시기를 결정하기 위해서, 객혈환자 118명의 의무기록을 후향적으로 분석하여 단순 흉부 X-선 소견, 출혈 양 및 출혈 지속기간과 기관지경검사의 시행시기와의 관계를 알아 보았다. 결과 : 1. 객혈의 원인은 활동성 폐결핵(34명, 28.8%), 비활동성 폐결핵(12명, 10.2%), 기관지확장증(20명, 17.0%), 폐암(9명, 7.6%), 폐국균종(9명, 7.6%), 그리고 기타가 10명(8.5%)이었고, 원인을 알수 없었던 경우가 24명(20.3%)이었다. 2. 출혈병소의 발견율은 기관지경검사를 일찍 시행 할수록 증가하였는데(p<0.05) 기관지경검사를 출혈 도중에 시행한 경우에는 24명의 환자중 21명(87.5%), 지혈된 후 24시간 이내에는 12명중 5명(41.7%), 그 후에 시행한 경우는 82명중 33명(40.2%)에서 출혈병소가 확인되었다. 3. 출혈병소의 발견율은 흉부사진 상 국소적이든 비국소적이든 병변이 보였던 경우에 더 높았다(p<0.05). 단순 흉부 X-선 소견에 관계없이 모든 경우에서 출혈 도중에 기관지경검사를 시행하면 출혈병소의 발견율은 증가하였다(p<0.05). 단순 흉부 X-선상 정상이거나 비국소적인 병변을 보이는 경우에는 출혈 도중이나 지혈 후 48시간 이내에 기관지경검사(조기 기관지경검사)를 시행했을 때 진단율은 증가하였다(p<0.05). 4. 기관지경에 의한 출혈병소의 발견율은 출혈 양이 많을수록 증가하였다(p<0.05). 비슷한 정도의 출혈 양을 보이는 경우에 기관지경검사를 조기에 시행하면 진단율이 증가하는 경향을 보였으나 통계적으로 유의 하지는 않았다(p>0.05). 5. 출혈병소의 발견율은 객혈의 지속기간과는 관계가 없었다(p<0.05). 그러나 객혈의 지속기간이 1주 미만이었던 경우 출혈 도중에 기관지경검사를 했을 때 증가하였다(p<0.05). 객혈의 지속기간이 1주 혹은 그 이상이면 기관지경검사의 시행시기에 따른 발견율의 차이가 없었다(p>0.05). 6. 조기 기관지경검사로 4명의 환자에서 정확한 출혈부위를 확인하여 폐절제술의 수술 부위를 결정하였으며, 1명에서는 기관지경을 통한 트롬빈 주입으로 객혈이 성공적으로 지혈되었다. 결론 : 객혈에서 굴곡성 기관지경검사는 출혈부위를 확인하는데 유용할 뿐만 아니라 치료방침을 결정하는 데에도 도움이 되며, 기관지경검사는 출현도중이나 지혈 후 48시간 이내에 조기에 시행하는 것이 바람직하다.

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경동맥 색전술을 이용한 십이지장 3부 게실 출혈의 성공적인 지혈: 증례 보고 (Successful Transcatheter Arterial Embolization following Diverticular Bleeding in the Third Portion of the Duodenum: A Case Report)

  • 홍석진;이상민;최호철;원정호;나재범;김지은;최혜영
    • 대한영상의학회지
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    • 제82권1호
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    • pp.237-243
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    • 2021
  • 본 증례는 73세 남자 환자가 십이지장 3부에서 발생한 상부위장관 출혈로 인해 경동맥 색전술로 치료한 드문 증례이다. 환자는 혈변을 주소로 내원하여 시행한 초기 상부 및 하부 위장관 내시경과 전산화단층촬영에서 출혈 부위를 발견하지 못하였다. 입원 3일째에 혈색소 수치가 지속적으로 감소하여 테크네슘-적혈구 스캔을 시행하였고 십이지장 3부의 게실 내에 출혈이 의심되어 혈관조영술을 시행하였다. 상장간동맥 혈관조영술에서 십이지장 게실에 혈류를 공급하는 하췌십이지장동맥의 활동성 출혈이 관찰되어 색전술을 시행하였다. 이후 7일 동안 재출혈이나 합병증이 없어 퇴원하였다. 이에 발생빈도가 매우 낮고 초기 진단이 어려웠던 십이지장 게실 출혈의 보고와 관련된 문헌고찰을 하고자 한다.

항혈소판제를 투여받는 환자의 치과치료 (Dental treatment of the patient with antiplatelet agent)

  • 박홍주
    • 대한치과의사협회지
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    • 제57권10호
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    • pp.606-612
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    • 2019
  • Antiplatelet agent is administered to the patients who have ischemic heart disease, transient cerebral infarction, as well as hypertension, etc. Antiplatelet agent prevents thromboembolism by inhibition of platelet aggregation by various mechanism. Due to that reason, patient who administered antiplatelet agent has bleeding tendency. Surgeon does not want to make a complication by bleeding during and after operation, and want to stop taking antiplatelet agent. However, It is very dangerous for the patient to stop antiplatelet agent. Local bleeding as a complication after operation is considered minor one, whereas thromboembolism is life threatening serious complication. Most dental intervention can be performed without withdrawal of antiplatelet agent. Dental intervention should be limited area, and surgeon should do active bleeding control.

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Patient Satisfaction, Vaginal Bleeding, Sexual Function following Laparoscopic Supracervical Hysterectomy

  • Jin, Keon
    • 여성건강간호학회지
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    • 제20권2호
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    • pp.148-154
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    • 2014
  • Purpose: This study was done to evaluate postoperative patient satisfaction, vaginal bleeding, and sexual function in women after laparoscopic supracervical hysterectomy (LSH). Methods: A retrospective study was conducted using a questionnaire mailed to 131 women who underwent LSH between 2008 and 2011at the Department of Obstetrics &Gynecology, D University Hospital in Chungnam province. Indication for LSH was uterine myoma. The questionnaire contained questions on overall postoperative satisfaction, influence on quality of life of vaginal bleeding, and sexual satisfaction following surgery. Data were collected from March to July 2013 and 109 (83.2%) patients returned the questionnaire. Results: Most women reported being very satisfied (90.8%) or satisfied (7.3%), but 2 women (1.8%) were not satisfied with LSH. Four patients (3.4%) reported experiencing vaginal bleeding but with no negative influence on quality of life. Of sexually active women, 82 patients (90.1%) reported improvements in sexual function, 8 patients (8.8%) reported "no change", and one patient (1.1%) reported a deterioration Conclusion: Results of this study indicate that LSH is associated with a high degree of patient satisfaction, no negative influence on quality of life from vaginal bleeding, and improvement in sexual function to a minimum 2 years after the procedure.

항응고제 투여중인 다발성 장애환자에서 골수이식전 발치창 출혈부의 전색과 배농술을 통한 출혈과 감염의 조절 : 증례보고 (BLEEDING & INFECTION CONTROL BY THE PACKING AND DRAINAGE ON BLEEDING EXTRACTION SOCKET BEFORE BONE MARROW TRANSPLANTATION IN A MULTIPLE DISABLED PATIENT WITH ANTICOAGULATION DRUG : REPORT OF A CASE)

  • 유재하;손정석;김종배
    • 대한장애인치과학회지
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    • 제8권1호
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    • pp.15-21
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    • 2012
  • Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.

Carbon Medicine in Ancient China

  • Yang, Hongyan;Fu, Zengxiang;Huang, Xingli;Ma, Binrui
    • Carbon letters
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    • 제6권4호
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    • pp.255-256
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    • 2005
  • In traditional Chinese medicine, some herbs are used after toasting or roasting. The process is called "Zhi Tan" in Chinese, which means charring, and the herbs after the treatment is called carbon medicine. Carbon medicine is widely used to arrest bleeding in traditional Chinese medicine. The paper introduces the records, development and applications of carbon medicine in ancient China. The earliest record found about carbon medicine was in the remains of Han dynasty (BC206-A.D.8). The paper also introduces the process of charring herbs and mechanism of carbon medicine in arresting bleeding. Calcium iron and tan released during the charring are believed as main factors for arresting bleeding, helped with porous surface structure of active carbon.

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간경화증과 구강전이 간암환자에서 과도한 재발성 치은출혈과 치통조절: 증례보고 (Severe Recurrent Gingival Bleeding and Toothache Control in a Patient with Liver Cirrhosis and Oral Metastatic Hepatoma: Report of a Case)

  • 이천의;모동엽;유재하;최병호;김종배
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권6호
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    • pp.592-596
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    • 2010
  • The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

2.45GHz CMOS Up-conversion Mixer & LO Buffer Design

  • Park, Jin-Young;Lee, Sang-Gug;Hyun, Seok-Bong;Park, Kyung-Hwan;Park, Seong-Su
    • JSTS:Journal of Semiconductor Technology and Science
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    • 제2권1호
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    • pp.30-40
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    • 2002
  • A 2.45GHz double-balanced modified Gilbert-type CMOS up-conversion mixer design is introduced, where the PMOS current-reuse bleeding technique is demonstrated to be efficient in improving conversion gain, linearity, and noise performance. An LO buffer is included in the mixer design to perform single-ended to differential conversion of the LO signal on chip. Simulation results of the design based on careful modeling of all active and passive components are examined to explain in detail about the characteristic improvement and degradation provided by the proposed design. Two kinds of chips were fabricated using a standard $0.35\mu\textrm$ CMOS process, one of which is the mixer chip without the LO buffer and the other is the one with it. The measured characteristics of the fabricated chips are quite excellent in terms of conversion gain, linearity, and noise, and they are in close match to the simulation results, which demonstrates the adequacy of the modeling approach based on the macro models for all the active and passive devices used in the design. Above all the benefits provided by the current-reuse bleeding technique, the improvement in noise performance seems most valuable.