• Title/Summary/Keyword: Bleeding evaluations

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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.

Comparison between minimally invasive plate osteosynthesis and the deltopectoral approach with allogenous fibular bone graft in proximal humeral fractures

  • Kim, Joon Yub;Lee, Jinho;Kim, Seong-Hun
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.136-143
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    • 2020
  • Background: The purpose of this study was to investigate the clinical differences between open reduction and plate fixation via a deltopectoral approach with allogenous fibular bone graft and a minimally invasive plate osteosynthesis (MIPO), in Neer's classification two-, threepart proximal humeral fractures. Methods: In this retrospective study, 77 patients with two-, three-part proximal humeral fractures were treated at two different institutions. Clinical and radiological evaluations were performed in 39 patients, who underwent MIPO at one institution (group A), and 38 patients, who underwent a deltopectoral approach with allo-fibular bone graft (group B) at another institution. The results between the groups were compared. Results: The MIPO technique was significantly less time consuming and caused less bleeding than the deltopectoral approach with allo-fibular bone graft (P<0.05). The duration of the fracture union was significantly reduced in group A (14.5±3.4; range, 10-22 weeks) compared to group B (16.4±4.3; range, 12-28) weeks (P<0.05). There were no statistically significant differences between the two groups when evaluating the visual analog scale and Constant scores between the two groups, 1 year postoperatively. In radiological evaluation, there was no difference in radiological outcomes between the two groups. There were no statistically significant differences in malunion between the two groups. Conclusions: The MIPO technique and deltopectoral approach with allo-fibular bone graft for two-, three-part proximal humeral fractures, show similar clinical and radiological results. However, allogenous fibular grafts require longer surgery, cause more bleeding, and result in longer fracture healing time than MIPO technique.

Successful Damage Control Resuscitation with Resuscitative Endovascular Balloon Occlusion of the Aorta in a Pediatric Patient

  • Heo, Yoonjung;Chang, Sung Wook;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.170-174
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

LONGITUDINAL CLINICAL STUDY ON THE EFFICACY OF OSSEOINTEGRATED DENTAL IMPLANTS IN PARTIALLY EDENTULOUS KOREAN PATIENTS: AN 8-YEAR PROSPECTIVE STUDY

  • Han Dong-Hoo;Bae Hanna Eun-Kyong
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.6
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    • pp.698-708
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    • 2001
  • This study was to evaluate the clinical evidence for the success and the predictability of the osseointegrated dental implants in the partially edentulous Korean patients. 201 patients have received total of 502 Branemark implants, which were restored with either single or multiunit fixed superstructures at the Implants Clinic, Yonsei University Dental Hospital. The clinical and radiographic evaluations carried out on the patients for maximum 8 years were assessed annually for peri-implant inflammation, implant mobility (PTV), Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), Keratinized Mucosa width and any changes in the surrounding bone level. The radiographs were taken at completion of the restoration, and annually thereafter. On the last recall appointments the patients filled a questionnaire consist of 29 questions in four categories. The cumulative non-failure rate of success was 93.9%. The first year mean bone loss was 0.3mm and less than 0.2mm annually thereafter. The periodontal parameters, keratinized tissue width and periotest values stabilized after initial changes in the first few years. The questionnaire has shown general satisfactory responses in all four aspect of dental implants treatment, including chewing efficacy, comfort, aesthetics and speech. The results support the predictability and success of the long-term rehabilitation of implant supported prostheses in partially edentulous Korean patients.

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Tailored Surgical Approaches for Benign Craniovertebral Junction Tumors

  • Jung, Seung-Hoon;Jung, Shin;Moon, Kyung-Sub;Park, Hyun-Woong;Kang, Sam-Suk
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.139-144
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    • 2010
  • Objective : We report our surgical experience in the treatment of 16 consecutive patients with benign craniovertebral junction (CVJ) tumor, observed from 2003 to 2008 at our department. Methods : We had treated 6 foramen magnum meningiomas, 6 cervicomedullary hemangioblastomas, 1 accessory nerve schwannoma, 1 hypoglossal nerve schwannoma, 1 C2 root schwannoma, and 1 cavernous hemangioma. Clinical results were evaluated by Karnofsky Performance Scale (KPS) and all patients underwent preoperative neuroradiological evaluation with computed tomography (CT) and magnetic resonance image (MRI). Angiography was performed in 15 patients and preoperative embolization was done in 2 patients. Results : Five far-lateral, 1 supracondylar and 10 midline suboccipital approaches were performed. Gross total removal was achieved in 15 cases (94%) and subtotal removal in 1 patient (6%). None of the patients required occipitocervical fusion. Radiological follow-up showed no recurrence in cases totally removed. Postoperative decrease of KPS scores was recorded in only 1 patient. The treatment of cervicomedullary solid hemangioblastoma presented particular issues : by preoperative embolization, we removed tumor totally without an excessive bleeding or brainstem injury. In one of foramen magnum meningioma, we carried out subtotal removal due to hard tumor consistency and encasement of neurovascular structures. Conclusion : The choice of surgical approaches and the extent of bone resection should be defined according to the location and size of individual tumors. Moreover, we emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon in tailoring the technique and providing the required exposure for different lesions, without unnecessary surgical steps.

Analysis on the Shape and Size of Sanitary Pads and User Experience Evaluation (여성위생용품 형태 및 사이즈 분석과 사용성 평가)

  • Kim, Yeon Soo;Kim, Sujeung;Lee, Sujin;Kim, Dong-Eun
    • Journal of the Korean Society of Clothing and Textiles
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    • v.44 no.3
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    • pp.485-498
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    • 2020
  • Sanitary pads are used with for the sanitization of menstruation bleeding. In this research, twenty medium size disposable sanitary pads were selected from domestic and international brands in order to analyze their shape and size. Additionally, 6 sanitary pads were selected among the 20, and user experience evaluations were completed. The analysis on the shape of the 20 sanitary pads showed that straight-shape pads existed more than curved-shape pads. The means of total pad length, wing length, wing width, front pad width, back pad width, front pad length, and back pad length were 24.5 cm, 8.8 cm, 3.0 cm, 10.0 cm, 10.2 cm, 11.6 cm, and 13.0 cm, respectively. All selected pads were medium size; however, detailed sizes varied between brands. Eighty-one women participated on user experience evaluation. Participants felt that brand F was the longest and brand D the shortest. The results matched with the results on actual pad length measurement. Participants evaluated the fit of brand E most positively and fit of brand A most negatively. The current study provides valuable information for developing disposable sanitary pads.

Successful Embolization in the Patient with Hemoptysis Due to Right Inferior Phrenic Artery-pulmonary Artery Anastomosis and Pseudoaneurysm (우하횡경막동맥-폐동맥 문합부위의 가성동맥류로 인한 객혈로 색전술 후 성공한 예)

  • Park, Hyun Woong;Lee, Go Eun;Park, Yong Sung;Son, Ji Woong;Choi, Eu Gene;Na, Moon Jun;Kwon, Sun Jung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.319-323
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    • 2009
  • The primary cause of hemoptysis is the bronchial artery. However, it should be noted that pulmonary artery and other vessels can cause hemoptysis. If the source of the bleeding is not determined after embolization, other evaluations are needed. Systemic-pulmonary anastomosis and pulmonary artery pseudo-aneurysm are rare vascular abnormalities with varying etiologies. An accurate and rapid diagnosis is needed in hemoptysis, since the cause may be life-threatening. We report a case of a 77-years-old man with persistent hemoptysis due to the right inferior phrenic artery - pulmonary artery anastomosis and pseudoaneurysm. After the embolization of the inferior phrenic artery, the hemoptysis was successfully treated.

Feasibility of Posterior Cervical Foraminotomy for Adjacent Segmental Disease after Anterior Cervical Fusion

  • Kim, Hyun Jun;Kang, Min Soo;Lee, Sang Ho;Park, Chan Hong;Chung, Seok Won;Shin, Yong Hwan;Lee, Shin Young;Park, Eun Soo
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.767-776
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    • 2020
  • Objective : The aim of this study is to evaluate the feasibility of posterior cervical foraminotomy (PCF) for adjacent segmental disease (ASD) after anterior cervical fusion (ACF). As ACF is accepted as the standard treatment for cervical spondylosis, many studies have been conducted to evaluate the efficacy of various surgical techniques to overcome symptomatic ASD after the previous surgery. Herein, PCF was performed for the treatment of symptomatic ASD and the feasibility of the surgery was evaluated. Methods : Forty nine patients who underwent PCF due to symptomatic ASD from August 2008 to November 2017 were identified. For demographic and perioperative data, the sex, age, types of previous surgery, ASD levels, operation times, and bleeding amount were recorded. The clinical outcome was assessed using the visual analogue scale for the neck and arm, the modified Odom's criteria as well as neck disability index. Radiologic evaluations were performed by measuring disc softness, disc height, the cervical 2-7 sagittal vertical axis, cervical cobb angle, and facet violation. Results : Thirty-seven patients were enrolled in this study. The patients were divided into two groups based on the location of the pathology; paracentral (group P) or foramina (group F). Both groups showed significant clinical improvement (p<0.05). The proportion of calcified disc and facet violations was significantly larger in group F (p<0.05). The minimal disc height decrease with mild improvement on sagittal alignment and cervical lordosis was radiologically measured without statistical significance in both groups (p>0.05). Conclusion : PCF showed satisfactory clinical and radiologic outcomes for both paracentral and foraminal pathologies of ASD after ACF. Complications related to anterior revision were also avoided. PCF can be considered a feasible and safe surgical option for ASD after ACF.

Maxillary tuberosity connective tissue graft for restoration of gingival depression in the anterior implant region (전치부 임플란트 영역 치은 함몰 회복을 위한 결체조직 이식술에서 상악결절 수여부의 선택)

  • Lee, Dong-Woon;Jung, Gwang-Young;Bang, Joo-Hyuk;Lee, Keun-Woo
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.102-111
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    • 2021
  • Implant placement in the anterior region is performed in several stages, and harmonization of both hard and soft tissues is essential. In addition, adequate esthetic and functional evaluations are necessary in the process of transitioning from the provisional to the final prosthesis to attain patient satisfaction. Although gingiva can be molded in the anterior region, depression in the occlusal view can yield good results through the augmentation procedure. However, the harvesting of connective tissue from the palate is not suitable for various reasons, such as postoperative discomfort and intraoperative bleeding. Compared to the palatal area, the harvesting of connective tissue from the maxillary tuberosity can easily result in relatively thick tissue and quick healing of the donor site, thus proving to be a good modality for graft procedures. The purpose of this report is to examine the relevant evidence from previous studies and evaluate the process of soft tissue augmentation through a case presentation.

An Experience of Cox-maze III Procedure for Chronic Atrial Fibrillation (만성 심방세동에 대한 Cox-maze III 수술의 임상경험)

  • 김삼현;박이태;서필원;박성식;류재욱;최창휴;김명아;이명용;김영권
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.668-673
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    • 1998
  • During the past several years, the maze operation has become the most effective method of treatment for chronic atrial fibrillation. When the maze procedure is done concomittantly with other cardiac operations, surgeons, in their initial experiences, may be concerned about the additional operative risks and uncertainty of the results. We performed the Cox-maze III procedure in six cases of chronic atrial fibrillation associated with mitral, mitral & aortic, or coronary arterial disease. Maze III procedure was done with open mitral commissurotomy(3 cases), mitral valve replacement(1 case), aortic and mitral valve replacement(1 case), and two-vessel coronary bypass graft(1 case). In spite of rather prolonged aortic cross clamp time, cardiac recovery was uneventful in all cases. No cases required reexploration for postoperative bleeding. All patients showed regular sinus rhythms immediate or between 2 and 20 days postoperateratively. Transient postoperative supraventricular arrhythmarias were easily controlled by various antiarrhythmic agents. In follow up evaluations, all cases showed regular sinus rhythm on ECG and the right and left atrial transport function was confirmed by Doppler echocardiography in all except one. Though our experience was limited in case number, the Cox-maze III procedure was effective in controlling the chronic atrial fibrillation without serious additional operative risks.

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