• Journal of Chest Surgery
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• 제28권12호
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• pp.1139-1143
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• 1995

We experienced 29 cases of patients with a chief complaint of hemoptysis who were performed pulmonary resection at the Department of Thoracic and Cardiovascular Surgery, Pusan Medical Center Hospital for 3 years from May 1990 to April 1993. The mean age of hemoptysis patients was 34.7 year old, and hemoptysis was most prevalent in third and fourth decades. The underlying lung diseases of hemoptysis patients were tuberculosis in 12[41.4% , bronchiectasis in 9[31.0% , lung cancer in 4[13.8% , aspergyllosis in 3[10.3% and pneumonia in 1[3.5% . Modes of hemoptysis were blood tinged in 7[24.1% , massive in 22[75.9% . Operation times were elective in 7[24.1% of all blood tinged hemoptysis, delayed in 20[69.0% , emergency in 2[6.9% out of massive hemoptysis. The cases of the definite bleeding focus found by bronchoscopy were 19 cases[65.5% . The operative procedures of hemoptysis were single lobectomy in 14[48.3% , pneumonectomy in 6[20.7% , lobectomy with segmentectomy in 5[17.2% , bilobectomy in 3[10.3% and segmentectomy in 1[3.5% . The postoperative results of hemoptysis were complete recovery in 27[93.0% , rehemoptysis in 1[3.5% which was treated by anti-Tbc medication completely, and hospital death in 1[3.5% which was brain metastasis of lung cancer. It was concluded that definitive diagnosis, preoperative control of hemoptysis and operation were important in the management of hemoptysis patients.

• Genomics & Informatics
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• 제12권4호
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• pp.225-230
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• 2014

Platelets are derived from the fragments that are formed from the cytoplasm of bone marrow megakaryocytes-small irregularly shaped anuclear cells. Platelets respond to vascular damage, contracts blood vessels, and attaches to the damaged region, thereby stopping bleeding, together with the action of blood coagulation factors. Platelet activation is known to affect genes associated with vascular risk factors, as well as with arteriosclerosis and myocardial infarction. Here, we performed a genome-wide association study with 352,228 single-nucleotide polymorphisms typed in 8,842 subjects of the Korea Association Resource (KARE) project and replicated the results in 7,861 subjects from an independent population. We identified genetic associations between platelet count and common variants nearby chromosome 4p16.1 ($p=1.46{\times}10^{10}$, in the KIAA0232 gene), 6p21 ($p=1.36{\times}10^{-7}$, in the BAK1 gene), and 12q24.12 ($p=1.11{\times}10^{-15}$, in the SH2B3 gene). Our results illustrate the value of large-scale discovery and a focus for several novel research avenues.

• Hip & pelvis
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• 제30권4호
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• pp.197-201
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• 2018

In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors. However, Asian patients who have undergone THA have a strikingly low prevalence of DVT and virtually no postoperative PE. Some authors suggest low clinical prothrombotic risk factors and the absence of some DVT-related genetic factors in Asian patient populations decrease the risk of DVT, PE or both. In Korea, the prevalence of DVT after THA without thromboprophylaxis have ranges from 6.8% to 43.8%, and asymptomatic PE have ranges from 0% to 12.9%; there have been only two reported cases of fatal PE. Deep-wound infections resulting from postoperative hematomas or prolonged wound drainage have been reported with routine thromboprophylaxis. The prevalence of DVT differs varies based on patient ethnicity. Guidelines for the use of thromboprophylaxis were altered and focus on the potential value of outcomes compared with possible complications (e.g., bleeding).

• 대한방사선기술학회지:방사선기술과학
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• 제42권3호
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• pp.195-199
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• 2019

Most of the vascular procedures performed for various diagnoses and treatments of various abdominal intervention procedures performed by the Department of Radiology and Angiography are performed by puncture of the femoral artery. For this reason, patients should undergo blood-related tests such as prothrombin time (PT) and partial thromboplatin time (PTT). Therefore, many patients are instructed to take precautions such as putting a sandbag on the puncture site to prevent delayed hemorrhage after hemostasis of the femoral artery puncture site, and not to bend the leg of the treated area for about 3 hours. Because of this, many patients have complained of pain during the procedure and inconvenience during the absolute bed rest time in the ward. The purpose of this study was to compare the safety of balloon ancillary devices with sandbags placed on the hemostasis site to prevent delayed hemorrhage after arterial puncture. We compared the safety of each patient with the results of medical records in consideration of the problem that the patient could not press with the focus, the position of the patient was changed depending on the patient's body shape, and the problem of falling down according to the location of the puncture site. As a result, the use of a balloon type ancillary device improves the effect of continuous hemostasis, reduces discomfort during the patient's absolute stabilization time, increases the patient's satisfaction, and is a good alternative to the existing sandbag.

• 한국콘텐츠학회논문지
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• 제19권2호
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• pp.269-276
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• 2019

본 연구는 제천시보건소 모자보건실을 이용하는 임산부를 대상으로 비외과적 치주처치 중심의 치위생관리 프로그램을 시범운영하고, 시범운영의 구조평가, 과정평가, 결과평가를 통하여 보건소에서 치과위생사가 지역사회 임산부를 대상으로 구강건강증진 프로그램을 운영하는데 기초자료로 제공하기 위해 수행되었다. 총 3회의 치위생관리 프로그램에 모두 참여한 9명의 임산부를 대상으로 하였다. 치위생관리 프로그램 결과 4mm 이상 치주낭 보유율은 40.4%에서 14.0%로(p<0.05), 치은출혈 치아 보유율은 4.6%에서 2.7%로(p=0.180), 치석형성 치아 보유율은 23.7%에서 0%로(p<0.05) 감소하였다. PHP Index(Patient Hygiene Performance index)는 2기 임산부의 경우 1차 1.7점에서 3차 1.4점으로 개선되었고, 3기 임산부의 경우 1차 2.4점에서 1.3점으로 개선되었다(p<0.05). 본 연구 결과 비외과적 치주처치 중심의 치위생관리 프로그램을 보건소 구강보건실에서 적용 및 확대할 수 있는 가능성이 높다는 것에 의의가 있으며, 향후 본 프로그램의 장기적인 운영과 지속적인 모니터링이 필요할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제65권5호
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• pp.396-399
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• 2008

객혈의 원인은 다양하고, 원인을 찾기 위해 침습적인 검사를 포함하여 여러 검사를 필요로 하는 경우가 있다. 인위성 객혈은 환자가 의도적으로 객혈을 만들어 내는 매우 드문 임상증상으로 간과되기 쉽다. 객혈 원인을 찾기 위한 여러 검사에서 특별한 이상소견이 없을 경우에는 인위성 객혈을 감별 진단해야 한다. 특히 본 증례와 같이 반복적인 객혈 호소와 극단적이고 이상한 임상 양상이나 보기 드문 행동을 하는 경우에는 인위성 객혈을 의심해 보아야 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.535-540
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• 2009

Proliferation of abnormal hematopoietic cells with impaired differentiation, regulation and programmed cell death leads to leukemia. AML(acute myeloid leukemia) is a malignancy with malfunction of myeloid hematopoietic cells with acute behavior. The oral manifestations of the disease are posterior palate hemorrhage, gingival bleeding and gingival ulceration as a result of infection by normal oral flora and gingival infiltration by leukemic cells. A 49-year-old male patient was referred from local dental clinic. The patient was diagnosed with AML FAB M1 (acute myeloid leukemia French-American-British classification M1 myeloblastic leukemia without maturation). The oral infection focus was removed by a conservative treatment. 2 days after the dental treatment, the patient underwent chemotherapy. At 8-month follow-up, the overall outcome was excellent. Oral manifestations of AML are often the first indications of the malignancy. Therefore it is essential for dentists, especially oral and maxillofacial surgeons, to be aware of the diagnostic signs and complications associated with leukemia for better diagnosis and subsequent treatment and management.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.179-183
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• 2016

A 59-year-old man presented with acute dyspnea following sudden productive cough and expectoration of a full cup of "blood-tinged" sputum. He had been diagnosed with hepatitis B virus-related hepatocellular carcinoma and had received transarterial chemoembolization 5 years ago for a 20-cm hepatic mass; he denied any history of hematemesis and the last esophagogastroduodenoscopy from a year ago showed absence of varix. Chest computed tomography (CT) with angiography showed new appearance of right basal lung consolidation but no bleeding focus. Despite the use of systemic antibiotics, the patient developed respiratory failure on day 7 of hospitalization. After intubation, a massive amount of brown sputum with anchovy-paste-like consistency was suctioned via the endotracheal tube. Bronchoscopic toileting was performed and the patient was extubated. In the ward, he continued to expectorate the brown sputum. On day 25 of hospitalization, a repeat CT scan showed simultaneous disappearance of the pneumonic consolidation and the necrotic fluid within the hepatic mass, suggesting the presence of a fistula. He has continued to receive systemic antibiotics, sorafenib, and entecavir, and follow up by respiratory and hepato-oncology specialists.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권4호
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• pp.296-299
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• 1998

After orthognathic surgery, postoperative complications are studied by many clinician. The complications include sensory disturbance, jaw fracture, excessive bleeding, condylar positional changes and loss of pulp vitality. Few surgical procedures are as satisfying for the surgeon and patient as a well-done orthognathic surgery. On the other hand, the patient is more satisfied with the result than who are treated with only orthodontic treatment especially in severe deformity case. There are problems that patient overcome but it is not serious complications. One of these, the problem about loss of pulp vitality can't influence function but give a lot of discomfort to the patient. From September 1997 to January 1998, 7 patients who are treated for dentofacial deformity via Le Fort I osteotomy or anterior segmental osteotomy were examined pulp sensitivity using digital pulp tester. This preliminary study have a focus on the investigation of recovery of pulp vitality. The electric pulpal test were used at preoperative, postoperative, at intervals. And we report some results acquired from this study. Follwing result are obtained 1. In anterior segmental ostetomy case (1 case), total 12 teeth were examined. Postoperative 8 weeks, 1 tooth are positive reaction 2. In Le Fort I osteotomy case (6 case), total 71 teeth were examined. Postoperative 8 weeks, 5 teeth are positive reaction

• Archives of Plastic Surgery
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• 제36권5호
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• pp.555-558
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• 2009

Purpose: The high success rate of free flap transfers is well documented in previous literature, and is possible due to the early detection of vascular compromise and timely reoperation. We specifically analyzed the operative results of immediate and delayed reconstruction with free transverse rectus abdominis musculocutaneous(TRAM) flap respectively in order to reveal its distinctive features on timing and causes of vascular compromise. Methods: The senior author operated on 158 patients, 161 cases of free TRAM flap for breast reconstruction. 51 patients underwent delayed reconstruction, whilst immediate reconstruction was performed in the other 107 patients. All patients were monitored every 3 hours for the first 3 days. We reviewed medical records of all patients, and tested statistical significance with the Fisher's test. Results: Reoperation was performed in 20 cases, but the cases include hematoma with bleeding focus and arterial anastomosis site rupture due to abrupt arm abduction. We performed reoperation in 15 cases of suspicious vascular compromise. Flap compromise was noticed mostly within 24 hours, but not longer than 72 hours. Venous compromise was dominant by 11 cases (73.3%). There was difference in the timing of flap compromise between immediate and delayed reconstruction. All the cases of delayed reconstruction did not show signs of vascular compromise after 12 hours postoperatively. On the other hand, cases of vascular compromise were observed until 72 hours postoperatively in cases of immediate reconstruction. Conclusion: Delayed reconstruction showed vascular compromise within 12 hours postoperatively, while immediate reconstruction showed compromised until the 3rd postoperative day. If more aggressive monitoring is maintained during this period, we believe salvage of flaps may be increased with more efficiency.