• 제목/요약/키워드: hemostasis

검색결과 224건 처리시간 0.019초

식도위 문합술후 재협착증에 대한 microwave 조직응고법적 치험 례 (An Experience of The Microwave Tissue Coagulation Therapy in The Restenosis of The Esophagogastrostomy)

  • 남충희;안욱수;이길노
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.859-864
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    • 1987
  • The microwave tissue coagulator was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases. We experienced the good result of the microwave tissue coagulation therapy in the patient with the restenosis of esophagogastrostomy. The patient was 67 year-old female, who was admitted due to the lye stricture of esophagus for 40 years. We made the lower esophagectomy and the esophagogastrostomy with the upper intact esophagus in the right thorax. But the restenosis occurred at the esophagogastrostomy site because of the polypoid mucosal protrusion at one month after operation. We applied the microwave tissue coagulator 3 times with 6 day interval under esophagoscopy and the good symptomatic and endoscopic relief was alleviated. We think that the microwave tissue coagulation is a very convenient and advisable method in the case of restenosis after esophageal surgery.

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Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury

  • Kim, Seong Joon;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • 제53권3호
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    • pp.180-182
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    • 2013
  • We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.

기관 재건술후 발생한 협착증에 대한 Microwave 조직응고법을 이용한 치료 -1례 보고- (A Micorowave Tissue Coagulation Therapy in the Restenosis of the Tracheal Reconstruction -A Case of Report-)

  • 김남혁
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.416-418
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    • 1995
  • The microwave tissue coagulation therapy was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases.We experienced one case of the restenosis after the tracheal reconstruction. The patient, who was 42 year-old male, had severe dyspnea due to the tracheal stenosis for 4 years. The resection of tracheal stenosis and tracheal reconstruction was done. But the restenosis occurred at the tracheal anastomosis site because of the protrusive granulation at one month after operation. The patient was successfully treated by the microwave tissue coagulation therapy.

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Evaluation of Bleeding After Denal Extraction in Patients Taking Single Antiplatelet Treatment

  • Kim, Jae Jin;Kim, Hak Kyun
    • International Journal of Oral Biology
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    • 제40권3호
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    • pp.147-150
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    • 2015
  • The purpose of this study was to evaluate the effect of single antiplatelet treatment on delayed bleeding, in patients undergoing dental extraction. A total of 154 teeth were extracted in 94 patients with ongoing antiplatelet treatment, who were taking single antiplatelet of either aspirin or clopidogrel. All patients underwent simple dental extraction; local hemostasis was performed with gauze-biting, suturing, and/or application of a local hemostatic agent. Delayed bleeding was recorded in 5 teeth out of a total of 154 teeth after extraction, the incidence of postoperative delayed bleeding being 3.2%. The bleeding was controlled by the patients themselves, through application of pressure with additional gauze-biting. No one visited the doctor or emergency room for hemostasis. These results confirmed that patients taking single antiplatelet drugs may have teeth extracted safely without interruption of the antiplatelet treatment.

와파린(Warfarin) 투여 환자의 치과 치료 (Management of Dental Patients taking Warfarin)

  • 박관수
    • 대한치과의사협회지
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    • 제57권10호
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    • pp.623-628
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    • 2019
  • Warfarin is an anticoagulant involved in the production of vitamin K dependent blood clotting factors. Dentists should be familiar with the appropriate assessment methods and considerations for the treatment of patients taking warfarin. Dental surgery with the moderate risk of bleeding can be performed without stopping the drug through preoperative examination of the INR(international normalized ratio) value and evaluation. When performing a surgery with a high risk of bleeding, it is necessary to evaluate whether the drug can be discontinued, what the duration is, and the risk of discontinuation. Hemostasis can be obtained by local methods in most cases of postoperative bleeding in patients taking appropriately adjusted doses of warfarin.

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파노라마방사선영상에서 관찰되는 다발골수종: 증례보고 (Multiple myeloma: Report of two cases with emphasis on the panoramic imaging features)

  • 염한결
    • 대한치과의사협회지
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    • 제56권12호
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    • pp.707-713
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    • 2018
  • Multiple myeloma is a lymphohematopoietic disorder leading to abnormal hemostasis and significant pathologic changes of skeletal system. It induces multiple circular or oval-shaped radiolucent lesions which are characterized by 'punched-out appearance'. The surrounding trabecular bone normally shows no significant sclerotic reaction. Multiple myeloma patients may visit dental clinics, without perception of the disease themselves, due to discomfort from edema of orofacial region, oral ulcers, tooth mobility, pain or gingival bleeding. Multiple myeloma is susceptible to various complications, including delayed hemostasis and infection, which could occur during routine dental treatment such as periodontal and surgical operation. For radiographic diagnosis of multiple myeloma, common radiologic features of this tumor could be visualized by panoramic radiographs in the dental clinics, and further medical examinations and treatment can be recommended as a result.

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Analysis of ICU Treatment on Resection of Giant Tumors in the Mediastinum of the Thoracic Cavity

  • Kang, Nai-Min;Xiao, Ning;Sun, Xiao-Jun;Han, Yi;Luo, Bao-Jian;Liu, Zhi-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3843-3846
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    • 2013
  • Objective: The purpose of this study was to assess prognosis after resection of giant tumors (including lobectomy or pneumonectomy) in the mediastinum. Materials and Methods: Patients with resection of a giant tumor in the mediastinum of the thoracic cavity received ICU treatment including dynamic monitoring of vital signs, arterial blood pressure and CVP detection, determination of hemorrhage, pulmonary function and blood gas assay, treatment of relevant complications, examination and treatment with fiber optic bronchoscopy, transfusion and hemostasis as well as postoperative removal of ventilators by invasive and non-invasive sequential mechanical ventilation technologies. Results: Six patients were rehabilitated successfully after ICU treatment with controlled postoperative errhysis and pulmonary infection by examination and treatment with fiber optic bronchoscopy without second application of ventilators and tubes after sequential mechanical ventilation technology. One patient died from multiple organ failure under ICU treatment due to postoperative active hemorrhage after second operative hemostasis. Conclusions: During peri-operative period of resection of giant tumor (including lobectomy or pneumonectomy) in mediastinum ofthe thoracic cavity, the ICU plays an important role in dynamic monitoring of vital signs, treatment of postoperative stress state, postoperative hemostasis and successful removal of ventilators after sequential mechanical ventilation.

Comparison of hemostatic efficacy and cytotoxicity of three ferric subsulfate- and chitosan-based styptics in different formulations using a rat tail bleeding model

  • Byun, Jae-Young;Lee, Soojung;Lee, Jeong Ik;Yoon, Hun-Young
    • 대한수의학회지
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    • 제58권3호
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    • pp.119-124
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    • 2018
  • This study was conducted to compare the hemostatic efficacy of three ferric subsulfate- and chitosan-based styptics as a powder and a gel containing ferric subsulfate and chitosan (FSC-PO and FSC-G, respectively) and a soaked pad containing ferric subsulfate and lidocaine (FSL-SP) using a rat tail bleeding model. The cytotoxicity of the styptics against L-929 mouse fibroblasts was also evaluated using a cell counting kit-8 assay. Four groups of 10 rats each were assigned to the three different styptics and a non-treated control groups. Rat tail tips were transected, after which styptics were applied with pressure. The wounds were observed for hemostasis for 3 min, then irrigated with saline to check for recurrent hemorrhage. L-929 mouse fibroblasts were exposed to extracts of the styptics (100 mg/mL) and their dilutions (1:10, 1:100, and 1:1,000). FSC-PO and FSC-G more effectively controlled initial hemorrhage than FSL-SP (p = 0.033). Additionally, FSC-PO and FSC-G more effectively maintained hemostasis than the control group (p = 0.02 and p < 0.01, respectively). However, all styptics showed enhanced cytotoxicity against L-929 cells in a dose-dependent manner. Therefore, although FSC-PO and FSC-G would be recommended to control hemorrhage, the benefits of styptics must be balanced against the clinical significance of their cytotoxicity.

Angio-$Seal^{TM}$ $Evolution^{TM}$ versus Manual Compression for Common Femoral Artery Puncture in Neurovascular Diagnostic Angiography: A Prospective, Non-Randomized Study

  • Chung, Joon-Ho;Lee, Dong-Woo;Kwon, Ok-Sim;Kim, Bum-Soo;Shin, Yong-Sam
    • Journal of Korean Neurosurgical Society
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    • 제49권3호
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    • pp.153-156
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    • 2011
  • Objective : This prospective, non-randomized study compared the safety and efficacy of the Angio-$Seal^{TM}$ $Evolution^{TM}$ to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography. Methods : From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-$Seal^{TM}$ $Evolution^{TM}$ or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment. Results : Mean time to hemostasis was $0.42{\pm}0.04$ minutes for the angioseal and $15.83{\pm}1.63$ minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications. Conclusion : The Angio-$Seal^{TM}$ $Evolution^{TM}$ is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.

CO2 Laser와 Scalpel을 이용한 절개 시 돼지 방광에서의 창상치유 평가 (Comparative study of wound healing in porcine urinary bladder with CO2 laser and scalpel incisions)

  • 이재연;정성목;조성환;박창식;김명철
    • 대한수의학회지
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    • 제50권3호
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    • pp.247-251
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    • 2010
  • This study compared the instrument performance and tissue healing of a steel scalpel with a $CO_2$ laser in an animal urinary bladder surgery model. Landrace and Yorkshire mixed breed pigs were used. Two symmetrical incisions were made in urinary bladder of each pig. One incision was made on the left side of ventral aspect on urinary bladder using a steel scalpel, while the other incision was performed on the right side using a $CO_2$ laser with an 8W output power. Each instrument was evaluated clinically for speed, ease of incision, and extent of bleeding. At 7 and 21 days after initial wounding, each wound was taken for histological observations. The scalpel was an easier instrument to use in the confines of the urinary bladder tissue, compared with the laser. However, there was no significant difference between the two groups. The amount of bleeding was less in the laser group but the time of the incisions was shorter with the scalpel. Scalpel incisions showed complete restoration of the epithelium and muscularis. On the other hand, the laser incisions showed incomplete restoration of the epithelium and muscularis. However, most of wound healing in the laser incisions was accomplished according to the time lapse. Although the scalpel produced less damage to the urinary bladder tissue and was easier to handle than the $CO_2$ laser, it did not provide hemostasis that was helpful for use on highly vascular tissue. The $CO_2$ laser provided good hemostasis, but delayed wound healing. In conclusion, the $CO_2$ laser provided better hemostasis and better surgical field than the scalpel. The $CO_2$ laser was used effectively in urinary bladder incision.