• Journal of radiological science and technology
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• v.42 no.3
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• pp.181-186
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• 2019

Transarterial chemoembolization is one of the most representative procedures for puncture of the femoral artery. In addition, the same procedure is often repeatedly performed many times, and Hepatocellular carcinoma patients due to cancer is significantly lowered blood tests, regardless of platelet counts are not good enough to stop bleeding. More importantly, hepatocellular carcinoma has a high degree of complication and disease severity, which makes it less likely that the condition of the body will be relatively inferior to other patients. In order to prevent delayed hemorrhage of the femoral artery puncture site after the procedure, it is advised to absolutely stabilize the limb so that it does not bend the limb for 3 hours after climbing in the ward. Therefore, I have been complaining about inconvenience. In addition, in order to prevent delayed hemorrhage after hemostasis, balloon type hemostatic device was used instead of sand bag which was placed on hemostatic site. The results of this study were compared with the results of actual application. The use of a balloon-type hemostatic device to increase the effectiveness of continuous hemostasis and to minimize the inconvenience during the time of patient's absolute bed rest, rather than raising the sandbag to prevent primary delayed hemorrhage by various methods in transarterial chemoembolization. It can be used as a substitute for existing sand bags because it can alleviate pain, increase satisfaction, and can be used as a disposable one.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.45-49
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• 2016

This study investigates the success rate of pulpotomy using electrosurgery operated on a primary molar in caries. The pulpotomy using electrosurgery was done on 253 primary molars of 111 young patients from 2 to 9 years old during the period of the first day of January 2011 to the last day of December 2015. After the amputation of pulp and hemostasis of primary molar were done using electrosurgery, MTA as pulp capping material was applied to the primary molar and the tooth was restored with the stainless steel crown. The follow up period after the treatment ranged from 4-46 months. The clinical and radiographic success rate ranged from 92.1 - 94.3%. Which is comparable to formocresol and ferric sulfate pulpotomy. Due to its non-pharmacological characteristic, electrosurgery can minimize harmful effect on the pulp tissue. Its fast bleeding control makes it easy and safe to use in pediatric and disabled patients in comparatively simple manner. Electrosurgery can be an alternative for pulp therapy considering the side effects of pharmacological ways.

• Korean Journal of Clinical Laboratory Science
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• v.41 no.1
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• pp.1-5
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• 2009

The Platelet Function Analyzer (PFA)$^{(R)}$-100 measures the ability of platelets activated in a high-shear environment to occlude an aperture in a membrane treated with collagen and epinephrine (CEPI) or collagen and ADP (CADP). The time taken for the flow across the membrane to stop (closure time, CT) is recorded. The aim of this study was to assess the potential of the PFA$^{(R)}$-100 as a primary clinical screening tool using the wide spectrum of clinical samples assessed for platelet function as well as to perform the optimal algorithm for the use of PFA$^{(R)}$-100. We established the reference interval in 460 hospital inpatients defined as having normal platelet function based on classical laboratory tests. The reference interval by using the range $5^{th}$ and $95^{th}$ percentile was 84~251 seconds for males CEPI-CT and 85~249 seconds for females CEPI-CT. A total of 1,200 inpatients were enrolled to identify impaired hemostasis before surgical interventions. The abnormal group showing prolonged CEPI-CT was 303 cases (18.9%). Only 3 cases had both abnormal CEPI-CT and CADP-CT. Several factors including sample errors, drugs, hematologic abnoralities were contributed to unexpected prolonged CEPI-CT for screening test. The von Willebrand factor (vWF:Ag) assay was performed only in one patient to verify the algorithm for the use of PFA$^{(R)}$-100. The PFA$^{(R)}$-100 was sensitive and rapid method for primary screening test of platelet dysfunction, so we can substitute it for the bleeding time in routine clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.248-253
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• 2013

Purpose: The aim of this study was to compare the efficacy and safety of band ligation and injection sclerotherapy in the endoscopic treatment of children with variceal bleeding. Methods: The study population included 55 children, all of whom were treated at the time of endoscopic diagnosis of esophageal varices at Asan Medical Center, Seoul, Korea, between January 1994 and January 2011. The primary outcomes included initial success rates and duration of hemostasis after endoscopic management (band ligation vs. injectionsclerotherapy). Results: The mean age was $6.7{\pm}5.2$ years and the mean follow-up time was $5.4{\pm}3.7$ years. The most common cause of esophageal varices was biliary atresia. Of 55 children with acute variceal bleeding, 39 had band ligation and 16 had injection sclerotherapy. No differences between groups were observed in terms of the size, location, and presence of red color sign. The success rates of band ligation and sclerotherapy in the control of acute bleeding episodes were 89.7% and 87.5%. The mean duration of hemostasis after endoscopic intervention was $13.2{\pm}25.1$ months. After one year, 19 of 39 patients (48.7%) treated with band ligation and 7 of 16 patients (43.8%) with injection sclerotherapy had experienced rebleeding episodes. Complications after the procedures were observed in 10.3% and 18.8% of children treated with band ligation and injection sclerotherapy. Conclusion: The results of our current study suggest that band ligation and injection sclerotherapy are equally efficient treatments for the control of acute variceal bleeding and prevention of rebleeding.

• Clinical and Experimental Pediatrics
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• v.63 no.3
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• pp.79-87
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• 2020

Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual processes involved in platelet production and hemostasis are genetically controlled; to date, mutations of more than 50 genes involved in various platelet biogenesis steps have been implicated in IPDs. Representative IPDs resulting from defects in specific pathways, such as thrombopoietin/MPL signaling; transcriptional regulation; granule formation, trafficking, and secretion; proplatelet formation; cytoskeleton regulation; and transmembrane glycoprotein signaling are reviewed, and the underlying gene mutations are discussed based on the National Center for Biotechnology Information database and Online Mendelian Inheritance in Man accession number. Further, the status and prevalence of genetically confirmed IPDs in Korea are explored based on searches of the PubMed and KoreaMed databases. IPDs are congenital bleeding disorders that can be dangerous due to unexpected bleeding and require genetic counseling for family members and descendants. Therefore, the pediatrician should be suspicious and aware of IPDs and perform the appropriate tests if the patient has unexpected bleeding. However, all IPDs are extremely rare; thus, the domestic incidences of IPDs are unclear and their diagnosis is difficult. Diagnostic confirmation or differential diagnoses of IPDs are challenging, time-consuming, and expensive, and patients are frequently misdiagnosed. Comprehensive molecular characterization and classification of these disorders should enable accurate and precise diagnosis and facilitate improved patient management.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.631-639
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• 1996

Electrosurgical technique have been used in dentistry as an aid to soft tissue management for nearly 60 years. However, it was not until the late 1960s that the principles of electrosurgery were understood and improved equipment became available. Electrosurgery is a surgical procedure performed on soft tissue utilizing controlled high frequency electricaI(radio-frequency) currents in the range of 1,500,000 to 7,500,000 cyclesper second. The radio-frequency energy used in electrosurgery is able to cut and coagulate tissue because it focuses the energy at the small, active electrode. Advantages of electrosurgery for soft-tissue management during dental procedures include improved hemostasis, ease of tissue modification, improved visibility and so on, but adverse healing responses-including necrosis of soft tissue and sequestration of alveolar bone-have been reported. The present report provides examples of treatment of soft tissue and pulp tissue of primary teeth by electrosurgery. The results are as follows; 1. Electrosurgical techniques can be used for various procedures in pedodontics. 2. Electrosurgical procedures provide improved hemostasis and visibility in the operating field, which enable to remove, reshape, and contour soft tissues easily. 3. In pulpotomy technique, it was difficult to expect the variable pulpal response based on the degree of heat accumulation and the conditions of pulp tissues. Therefore, electrosurgical pulpotomy could not be considered as a method superior to formocresol pulpotomy. 4. A greater degree of dexterity and experiences in manipulation of the electrode is required compared with the conventional scalpel surgery.

• Journal of Interdisciplinary Genomics
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• v.3 no.2
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• pp.41-46
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• 2021

Inherited platelet function disorders (IPFDs) are a disease group of heterogeneous bleeding disorders associated with congenital defects of platelet functions. Normal platelets essential role for primary hemostasis by adhesion, activation, secretion of granules, aggregation, and procoagulant activity of platelets. The accurate diagnosis of IPFDs is challenging due to unavailability of important testing methods, including light transmission aggregometry and flow cytometry, in several medical centers in Korea. Among several IPFDs, Glanzmann thrombasthenia (GT) is a most representative IPFD and is relatively frequently found compare to the other types of rarer IPFDs. GT is an autosomal recessive disorder caused by mutations of ITGA2B or ITGB3. There are quantitative or qualitative defects of the GPIIb/IIIa complex in platelet, which is the binding receptor for fibrinogen, von Willbrand factor, and fibronectin in GT patients. Therefore, patients with GT have normal platelet count and normal platelet morphology, but they have severely decreased platelet aggregation. Thus, GT patients have a very severe hemorrhagic phenotypes that begins at a very early age and persists throughout life. In this article, the general contents about platelet functions and respective IPFDs, the overall contents of GT, and the current status of genetic diagnosis of GT in Korea will be reviewed.

• The Korean journal of helicobacter and upper gastrointestinal research
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• v.18 no.4
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• pp.225-230
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• 2018

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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• pp.843-848
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• 1998

Pulpotomy is a frequently used treatment modality in primary teeth. It is method by which infected coronal pulp is removed while retaining vital radicular pulp. Since its introduction in 1930 by Sweet formocresol remains the most popular medicament for this treatment. However, despite its outstanding bactericidal properties, formocresol is known to cause adverse tissue reactions. Theoretically, formocresol disinfects and fixes radicular pulp and thus prevents infection and internal resorption. In reality, however, it leads to chronic inflammation and is sometimes responsible for failures through abscess formation and internal root resorption. Also, Myers et al., in 1978, reported on the systemic distribution of FC and other studies have followed with reports of its immunological, mutagenic and carcinogenic effects. Much effort has, therefore, focused on the development of alternative medicaments and techniques. Since its introduction in 19C, ferric sulfate proven itself as an effective hemostatic agent and is used as an astringent in dentistry. In 1988, Landau and Johnsen suggested ferric sulfate be used as a medicament in pulpotomy and many studies have focused on it to overcome the toxic effects of FC. Ferric sulfate acts through its ferric ion and iron ion, which react with blood protein leading to aggregation. The aggregated protein acts to plug the blood vessels, causing mechanical hemostasis. As blood clot formation is minimal, there is reduced inflammation of radicular pulp and enhanced healing. There are no reports regarding its systemic distribution. This is a report of cases treated by the author using pulpotomy with ferric sulfate.

• Neonatal Medicine
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• v.18 no.1
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• pp.14-22
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• 2011

Neonatal bleeding is a common problem encountered in nursery rooms or neonatal intensive care units, especially among premature infants. Furthermore, owing to recent remarkable improvement of neonatology, survival rates of preterm neonates have increased; hence, neonatal bleeding cannot be emphasized enough. Since the total blood volume of neonates is small, bleeding can be one of the causes of morbidities and mortalities. Therefore, rapid diagnosis and immediate therapy is urgently needed. The patient's medical history including a familial history of a bleeding disorder or of a previously affected infant who suffered from bleeding along with maternal and neonatal drugs can provide important diagnostic clues. Presence of bleeding with or without petechiae and ecchymoses in a healthy term or late preterm infant with thrombocytopenia but normal prothrombin time and activated partial thromboplastin time strongly suggests a congenital bleeding disorder. For a sick infant who is bleeding from multiple sites, an acquired disorder such as disseminated intravascular coagulation is suspected. Intracranial hemorrhage in term or late preterm infants without a history of birth trauma is highly suggestive of coagulation disorders. The purpose of this review is to summarize recent advances in diagnostic methods is as well as basic concepts of neonatal hemostatic disorders. First, an outline of background information will be presented followed by a discussion of primary and secondary hemostatic disorders as well as inherited and acquired disorders.