• Korean Journal of Radiology
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• v.21 no.4
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• pp.422-430
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• 2020

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.311-316
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• 2009

Background: Clopidogrel is widely used just before coronary artery bypass surgery, yet its pharmacological effect can cause postoperative bleeding-related complications. The purpose of this study was to find the effect of preoperative clopidogrel exposure on the blood transfusion requirement and on the rate of reexploration for bleeding control and the rate of readmission caused by bleeding in patients who undergo off-pump coronary artery bypass surgery (OPCAB). Material and Method: This study included 103 patients who had been on clopidogrel preoperatively and they underwent OPCAB by one surgeon from January, 2005 to November, 2007. We divided the patient into two group. Group 1 consisted of 45 patients who stopped cloidogrel 5 days before surgery and group 2 consisted of 58 patients who were taking clopidogrel within 5 days before surgery. Two groups were compared in terms of the bleeding related reoperation rate and the readmission rate, the amount of postoperative bleeding and the required amount of transfusion. Result: There were no significant differences between the two groups concerning the demographic, echocardiographic and hematologic features. There were no significant differences in the postoperative bleeding amount, but the amount of required transfusion was greater in group 2 (p=0.018). While group 1 showed a 0% reoperation rate for hemostasis and 0% readmission rate as related to postoperative bleeding, group 2 showed a 6.9% reoperation and a 5.2% readmission rate, but three were no statistically significant differences between the two groups. Conclusion: Continuous use of clopidogrel did not cause postoperative major bleeding, but can increase the amount of bleeding and the amount of required transfusion postoperatively. We that discontinuation of clopidogrel for a while before elective OPCAB can help the patient's postoperative recovery.

• Journal of Life Science
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• v.20 no.5
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• pp.710-716
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• 2010

This study was conducted to investigate the effect of Makgeolli (MG) and Makgeolli GiGemi (MGG) on blood flow, serum lipid improvement in vivo, and inhibition of angiotensin converting enzyme (ACE) in vitro. The activities of serum AST and ALT were increased by ovariectomy. Serum AST levels were decreased to $77.71{\pm}13.97$ and $74.57{\pm}14.90\;unit/ml$ in the OVX-MG50 and OVX-MGG50 groups compared to the OVX-control group ($91.14{\pm}12.02\;unit/ml$). Serum ALT levels were decreased to $34.00{\pm}8.41$ and $30.43{\pm}3.60\;unit/ml$ in OVX-MG50 and OVX-MGG50 groups compared to the OVX-control group ($37.14{\pm}5.40\;unit/ml$). Serum total cholesterol and triglyceride contents decreased in the sham group compared with OVX-control group by ovariectomy. Six weeks feeding of MG and MGG resulted in a decrease to $116.14{\pm}36.02$ and $109.14{\pm}11.55\;mg/dl$ compared to the OVX-control group ($120.43{\pm}8.36\;mg/dl$) in serum total cholesterol, and triglyceride levels were decreased to $52.43{\pm}12.41$ and $47.29{\pm}12.08\;mg/dl$ in the OVX-MG50 and OVX-MGG50 groups compared to the OVX-control group ($58.57{\pm}5.47\;mg/dl$). The level of HDL-cholesterol in the OVX-control group was significantly reduced to $51.29{\pm}20.49\;mg/dl$ compared to the sham group ($72.29{\pm}10.29\;mg/dl$), but it was increased to $70.71{\pm}19.53$ and $62.00{\pm}20.20\;mg/dl$ with MG and MGG supplementation. Furthermore, the effect of the MG group was higher than the MGG group. Microscopic observation showed that whole blood passed smoothly through the micro channels in the MG and MGG supplemented groups. The platelet aggregation ability of the groups treated with MG and MGG was less than that of the OVX-control group. In vitro assay, the angiotensin converting enzyme (ACE) activity was significantly inhibited by MG and MGG (82.6% and 68.9% inhibition at 0.4 g/ml). These results suggest that the beneficial effects of MG and MGG may be used to improve on the lipid metabolic syndrome of menopausal women. In addition, MG and MGG might improve blood homeostasis mediated activities via antiplatelets and MG and MGG may be used as antihypertensive functional foods and nutraceuticals.