• Journal of Trauma and Injury
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• 제37권3호
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• pp.209-213
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• 2024

Purpose: Trauma patients are at an elevated risk of developing venous thromboembolism (VTE), with the subsequent mortality in patients requiring intensive care unit admission ranging from 25% to 38%. There remains significant variability in clinical practice related to VTE prophylaxis in trauma patients due to the frequent presence of contraindications impacting the timing and consistency of application. This study aimed to assess the effectiveness of the current practice of chemical VTE prophylaxis in trauma patients at a single Australian center. Methods: A prospective review was conducted on patients admitted to the ACT Trauma Service (Canberra, Australia) from July to November 2022. The included patients were 18 years or older, without a direct contraindication to anticoagulation, who received chemical VTE prophylaxis with low-molecular-weight heparin (enoxaparin) for at least three doses and underwent subsequent testing of anti-factor Xa (aFXa) levels. Results: During the study period, 187 patients were admitted, of whom 63 were included in the study. Of these, 47 patients achieved therapeutic levels of anticoagulation as determined by their aFXa levels, while 16 were subtherapeutic. The only statistically significant difference between the two groups was in weight, with patients in the subtherapeutic group weighing an average of 91.9 kg compared to 79.1 kg in the therapeutic group (P<0.05). Conclusions: A fixed-dose enoxaparin regimen was utilized, with limited individualization based on patient factors, such as injuries, comorbidities, and other biological factors. Sixteen patients (25%) had subtherapeutic VTE prophylaxis, as measured by aFXa levels. Higher weight was significantly correlated with inadequate VTE prophylaxis dosing. While age, sex, and smoking status might play important roles in clinical decision-making, weight-based dosing of low-molecular-weight heparin may be more effective in achieving adequate VTE prophylaxis.

• 한국결정성장학회지
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• 제7권1호
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• pp.6-17
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• 1997

Czochralski법으로 용융상태에서의 조성이 congruent(48.6 mol%$Li_2O$), stoichiomet-ric(50.0 mol%$Li_2O$), Li-rich(54.6 mol%$Li_2O$, 58 mol%$Li_2O$), 한 결정과 congruent한 조성에 $K_2$O를 6wt.% 첨가한 결정을 c-축 방향으로 성장시켰다. 성장된 결정들은 분말 X-선 회절 실험에 의해 확인하고 편광 현미경과 투과 X-선 Laue법에 의해 축을 결정한 후 절단하여 65 mol%$Li_2O$의 Li-rich 2-phase powder에서 VTE 처리한다. VTE 처리한 시료는 상온에서 결정내 $Fe^{3+}$ 이온에 대한 EPR 스펙트럼과 UV-스펙트럼을 측정하고 이 온도에서의 IR-스펙트럼은 $OH^-$ 이온 농도를 증가시키기 위하여 수증기 분위기에서 열처리한 후 측정한다. 측정 결과를 as grown 상태의 결정에 대한 결과와 비교 분석한다. 상온에서의 결정내 $Fe^{3＋}$ 이온에 대한 EPR 실험 결과 VTE 처리한 시료들의 EPR 스펙트럼은 허용되지 않은 천이에 의한 스펙트럼이 사라지고 허용된 천이에 의한 스펙트럼은 세기가 증가하며 lineshape가 거의 대칭적으로 되고 선폭도 훨씬 줄어든다. 상온에서의 각 시료에 대한 UV-스펙트럼의 흡수단은 VTE 처리하면 단파장쪽으로 이동하며 VTE 처리한 모든 시료의 흡수단이 거의 동일하다. $OH^-$이온에 의한 IR-흡수 스펙트럼은 VTE 처리한 시료의 경우 $3465\textrm{cm}^{-1}$ 성분 스펙트럼이 현저하게 중가한다. 이 결과에 의하면 본 실험과 같은 조건에서 VTE 처리한 시료들은 결정내 [Li]/[Nb] 비가 거의 1인 stoichiometric한 결정이 되었음을 알 수 있다.

• 한국간호교육학회지
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• 제19권4호
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• pp.531-541
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• 2013

Purpose: This study was done to examine the relationship among knowledge, health belief, and preventitive behavioral intention related to venous thromboembolism (VTE) in patients with lower-limb musculoskeletal disorders. Methods: This transversal descriptive study looked at 145 adult patients with lower-limb musculoskeletal disorders, who were hospitalized in C hospital in G city. Data were collected from September 29 to October 6, 2012. Knowledge, health belief and preventitive behavioral intention were measured by structured questionnaires. Date were analyzed by descriptive statistics, one-way ANOVA, independent t-test, and Pearson correlation, using the SPSS program. Results: The mean score of knowledge related to VTE was low. The mean scores of health belief and preventitive behavioral intention related to VTE were moderate or higher than average. Preventitive behavioral intention positively correlated with knowledge, perceived benefit, and health motivation. Whereas, there was a negative correlation between preventitive behavioral intention and perceived barriers. Conclusion: These results suggest that developing a health care program which is able to enhance knowledge, perceived benefit, and health motivation related to VTE and reduce perceived barriers, is essential in order to promote preventitive behaviors.

• 한국재료학회지
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• 제16권8호
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• pp.479-484
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• 2006

Highly c-axis oriented poly-crystalline GaN with a dimension of $1{\sim}3\;{\mu}m$ was deposited on $c-Al_2O_3$ substrate by vapor transport epitaxy (VTE) method at the temperature range of $900{\sim}1150^{\circ}C$. XRD intensities from (00'2) plane of grown GaNs were increased with reaction conditions which indicate the improvement of the crystal quality. In the PL spectra measured at 10 K, the spectrum composed with the neutral-donor bound exciton-related emission at 3.47 eV, crystal defect-related emission band at 3.42 eV and with its phonon replicas. The fact that intensity of $I_2$ were increased and FWHM were decreased with growth conditions means that the quality of GaN crystals were improved. With this simple VTE technology, we confirm that the GaNs were simply deposited on sapphire substrate and crystal quality related to optical properties of GaN grown by VTE were relatively good. PL emission without deep level emission in spite of polycrystalline structure can be applicable to the fabrication of large area and low cost optical devices using poly-GaN grown by VTE.

• Molecules and Cells
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• 제24권2호
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• pp.301-306
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• 2007

Tocopherols, essential components of the human diet, are synthesized exclusively by photosynthetic organisms. To increase tocopherol content by increasing total flux to the tocopherol biosynthetic pathway, genes encoding Arabidopsis homogentisate phytyltransferase (HPT/V-TE2) and tocopherol cyclase (TC/VTE1) were constitutively overexpressed in lettuce (Lactuca sativa L.). Total tocopherol content of the transgenic plants overexpressing either of the genes was increased by more than 2-fold mainly due to an increase in ${\gamma}$-tocopherol. However, chlorophyll content in the HPT/VTE2 and TC/VTE1 transgenic lines decreased by up to 20% and increased by up to 35%, respectively (P < 0.01). These results demonstrate that manipulation of the tocopherol biosynthetic pathway can increase or decrease chlorophyll content depending on the gene introduced.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.105-110
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• 2014

Venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis, is an important cause of morbidity and mortality. The aim of this review is to summarize the findings from clinically important publications over the last year in the area of VTE. In this review, we discuss 11 randomized controlled trials published from March 2013 to April 2014. The COAG and the EU-PACT trials indicate that pharmacogenetic testing has either no usefulness in the initial dosing of vitamin K antagonists or marginal usefulness in the Caucasian population. Recent clinical trials with novel oral anticoagulants (NOACs) have demonstrated that the efficacy and safety of rivaroxaban, apixaban, edoxaban, and dabigatran are not inferior to those of conventional anticoagulants for the treatment of VTE. The PEITHO and ULTIMA trials suggested that rescue thrombolysis or catheter-directed thrombolysis may maximize the clinical benefits and minimize the bleeding risk. Lastly, riociguat has a proven efficacy in treating chronic thromboembolic pulmonary hypertension. In the future, NOACs, riociguat, and catheter-directed thrombolysis have the potential to revolutionize the management of patients with VTE.

• 한국임상약학회지
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• 제26권3호
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• pp.195-200
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• 2016

Background: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. Methods: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. Results: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. Conclusion: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.

• 한국자기학회지
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• 제15권2호
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• pp.118-124
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• 2005

용융상태의 조성비와 동일하게 성장된 $LiNbO_3$(CLN) 단결정은 많은 내부결함으로 인하여 예리한 전자스핀 공명신호를 관측하기가 어려운데, VTE(Vapor Transport Equilibrium) 처리로 내부결함의 농도를 감소시켜주면 공명신호가 좀 더 날카롭게 관측되어 더 정밀한 스핀 하밀톤 함수의 매개상수를 결정할 수 있다. 본 연구에서는 성장된 CLN에서 알아보기 힘들었던 $Nd^{3+}$와 $Er^{3+}$의 초미세 구조를 VTE 방법으로 처리한 시료로 액체헬륨 온도에서 관측하고, 실험적으로 얻은 스펙트럼의 비등방성에서 자성이온 주위의 국소구조에 대하여 논의하였다. 분석 결과로부터 $Nd^{3+}$와 $Er^{3+}$ 희토류 이온은 $LiNbO_3$결정 내에서 Li 자리를 선호한다는 것을 제안한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6705-6709
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• 2015

Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

• 임상간호연구
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• 제29권1호
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• pp.24-41
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• 2023

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.