• Journal of Chest Surgery
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• v.31 no.11
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• pp.1076-1080
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• 1998

Background: Spontaneous hemopneumothorax, occurring in 1% to 12% of patients with spontaneous pneumothorax, is a rare disorder that can potentially lead to life-threatening complications. Materials and methods: We have experienced 15 cases (2.28%) with spontaneous hemopneumothorax among 659 episodes of spontaneous pneumothorax for eight years, from 1990 to 1997, at our hospital. We studied our previously treated patients by retrospective case studies to determine the nature of optimal management. Results: There were 14 male and 1 female patients whose mean age was 27.5 years, ranging from 19 to 58. The sides with disorder were as following: right in 10 cases and left in 5, unilaterally. The amount of initial bleeding ranged from 400 to 1,500 mL and 8 patients received a homologous blood transfusion. Patients exhibited symptoms of chest pain, dyspnea, chest discomfort, and hypovolemic shock. We concluded that causes of this disease in our patients were a torn pleural adhesion (14 cases) and a rupture of vascularized bullae (1 case with an underlying intrinsic lung disease, tuberculosis). All patients underwent closed thoracostomy and had good results except for 3. One patient underwent thoracotomy within 3 days from the onset because of continuous active hemorrhage. Decortication was required in one case because of a reactive fluid collection in the pleural space, which led to impaired lung expansion. Another patient underwent thoracotomy due to a ipsilateral recurrent pneumothorax without blood collection. Conclusions: The goals of treatment include hemostasis and reexpansion of the collapsed lung. Thus, if patients arrive early at hospital, closed thoracostomy and transfusion are thought to be sufficient treatments, although early surgical repair has been considered recently.

• Journal of Life Science
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• v.18 no.11
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• pp.1493-1498
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• 2008

We defined factors affecting the postoperative outcome in adult cardiac surgery with cardiopulmonary bypass (CPB). Thirty-two adult patients scheduled for elective cardiac surgery participated in this study. Levels of leukocyte, glutamic oxaloacetic transaminase (GOT), troponin-I (cTNI), interleukin-6 (IL-6), D-dimer and neuron-specific enolase (NSE) were significantly elevated, whereas platelet count declined in cardiac surgery with CPB. GOT and D-dimer levels at CPB-off each had a positive significant correlation significantly with 24 hrs-bleeding, total bleeding, mechanical ventilatory assist time, ICU stay time and length of hospitalization. BUN levels at CPB-off were directly related to total bleeding, mechanical ventilatory assist time, ICU stay time and length of hospitalization. Platelet count at CPB-off was inversely related to mechanical ventilatory assist time, ICU stay time and length of hospitalization. Creatinine concentration at CPB-off interrelated positively with mechanical ventilatory assist time and ICU stay time. NSE levels at CPB-off had a positive relationship with postoperative 24 hrs-bleeding. The length of hospitalization was prolonged proportionally to the elevation of cTNI levels in cardiac surgery. Aortic cross-clamping and total CPB times also related with increase of 24 hrs and total bleeding volumes and the length of hospitalization. IL-6 and ET-1 had no mutual relation with any postoperative outcome. These data suggest that GOT, BUN, creatinine, D-dimer and platelet levels are the most important factors affecting postoperative outcomes and patient's recovery in adult cardiac surgery with CPB.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.20-26
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• 2016

Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

• The korean journal of orthodontics
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• v.39 no.6
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• pp.383-392
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• 2009

Objective: The purpose of this study was to evaluate the efficacy of a slim bristled toothbrush compared with a V-shaped orthodontic toothbrush in patients with fixed orthodontic appliances. Methods: Thirty four orthodontic patients receiving edgewise treatment were randomly assigned to two groups, a slim bristled toothbrush (Nano silver slim care) and a V-shaped toothbrush (Oral-B). Plaque index, gingival index and bleeding index were recorded at the beginning of the study (baseline), 2 weeks, 4 weeks and 6 weeks after new toothbrushes were supplied and the results were analyzed statistically. Results: No statistically significant differences were found for plaque index, gingival index and bleeding index between toothbrush groups during the 6 weeks. Plaque and gingival indices were decreased at 2 weeks and 4 weeks but increased at 6 weeks in both toothbrush groups. Bleeding index in the V-shaped toothbrush group showed the lowest value at 2 weeks then increased at 4 weeks and 6 weeks but in the slim bristled toothbrush group decreased from 2 weeks through 6 weeks to under baseline levels. Patients in their twenties had significantly lower values than teenagers in the slim bristled toothbrush group (p < 0.013). Conclusions: The results would suggest that both of the toothbrushes are equally effective but the use of a slim bristled toothbrush may be of benefit in promoting gingival health for fixed orthodontic appliance patients in their twenties and over.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.28-31
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• 1998

Homologous blood transfusion entails substantial risks, including allergic reactions, transmission diseases such as hepatitis, acquired immunodeficiency syndrome. Autotransfusion system is a common method of reducing the need for homologous blood transfusion during cardiac operation. Between July 1993 and July 1995, a series of 40 patients undergoing open heart surgery was selected to an autotransfusion group(n=20) or a control group(n=20). The cell saver system(AT1000, Electromedics, Englewood, CO, USA) was employed for autotransfusion. With this system, shed blood in operative field during cardiopulmonary bypass(CPB) and remained blood in cardiotomy reservior after CPB was aspirated by means of a locally heparinized collecting system. After centrifuge salvaged blood, the resulting red cell concentrate reinfused subsequently. The amounts of blood loss were 766.5$\pm$121.3 ml in cell saver group, 770.1$\pm$113.6 ml in control group, and there were no significant differences between two groups(P=NS). The amounts of blood transfused were 2.91$\pm$1.72 units in cell saver group, 4.82$\pm$1.72 units in control group. Composition of processed blood by cell saver was hemoglobin 17.4 gm%, hematocrit 56.4%, RBC 5,780,000/ul, WBC 9,900/ul, and platelet 33,000/ul. There was no complication related to cell saver. Conclusively, cell saver autotransfusion system is safe, effective method for reducing the homologous blood trasfusion in cardiac surgery.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.181-190
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• 2001

Purpose: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Sch$\"{o}$nlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. Methods: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. Results: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. Conclusion: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.

• The korean journal of orthodontics
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• v.34 no.4 s.105
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• pp.363-370
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• 2004

Patients with fixed orthodontic appliances frequently have increased levels of plaque accumulation leading to the possibility of gingivitis or enamel decalcification. Although many methods may be helpful in reducing dental plaque formation, the optimal mechanical removal of plaque is the most important factor during orthodontic treatment. The purpose of this study was to evaluate the efficacy of an electric toothbrush (with a specially designed orthodontic brush head) compared to a manual toothbrush in controlling plaque and gingivitis for patients with fixed orthodontic appliances. Oral hygiene status was measured in thirty-four patients using a plaque index, a gingival index and a bleeding index, before and four weeks after the attachment of fixed orthodontic appliances. Patients were randomly divided into two groups: electric and manual toothbrush groups. Oral hygiene instruction was given according to the type of toothbrush used. The Braun Oral-B D9511 with Braun Oral-B Ortho OD 15-1 brush head was used as the electric toothbrush while the Butler G.U.M. 124 was given as the manual toothbrush. After four md eight weeks, oral hygiene status was measured again. Through a comparison between the electric and the manual toothbrush groups, the following results were obtained. 1. All oral hygiene indices showed an increasing tendency after four weeks of fixed orthodontic appliance. 2. All indices presented a decreasing tendency four and eight weeks after oral hygiene instruction. 3. In case of the gingival index and bleeding index, the decreasing tendency did not show a statistically significant difference between the electric and the manual toothbrush groups. 4. The decreasing tendency of plaque index presented a statistically significant difference between the two groups, showing that the electric toothbrush was more effective in terms of oral hygiene. These findings suggest that an electric toothbrush is useful to orthodontic patients with fixed appliances.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.964-972
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• 1998

Background: The purpose of this study was to independently evaluate the beneficial effects of a high dose of transamine administrated prior to CPB on the postoperative hematologic aspect and bleeding. Materials and methods: This study included randomly selected groups of 40 adult patients undergoing OHS with CPB. All patients were divided into 2 groups: transamine group (T-group, n=20) and placebo group(P-group, n=20). The T-group received a high-dose of transamine(10 g) before and during CPB. The P-group received normal saline at the same times and served as a control group. Results: The results of comparative studies between the 2 groups in the same hematologic variables were summarized as follows. \circled1 During CPB, the fibrinogen concentrations and platelet counts were significantly lower in the P-group than in the T-group(p<0.01). \circled2 During CPB, production of D-dimer occurred in 18 patients(90%) in the P-group and did not occur in the T-group(0%) (p<0.0001). \circled3 At CPB-off, the % concentration of fibrinogen(70.2$\pm$3.9%) and the % platelet counts(72.4$\pm$4.5%) of the T-group were significantly higher than those(54.5$\pm$3.8%, 64.3$\pm$2.9%) of the P-group(p<0.01). \circled4 Postoperative values of PT(14.0$\pm$0.03 sec.) and aPTT (27.6$\pm$0.1 sec.) of the T-group were significantly lower than those(16.0$\pm$0.02sec., 30.1$\pm$0.1sec.) of the P-group(p<0.05). \circled5 Postoperative bleeding and requirement of whole blood and other blood products were significantly less in the T-group than in the P-group(p <0.05). \circled6 There were no significant hypercoagulability signs such as cerebral em bolism, myocardial infarction, pulmonary embolism, or any other neurological prob lems in either group. Conclusions: We concluded that a high dose of transamine administered prior to CPB prevents the activation of fibri nolytic system and has beneficial effects of reducing the postoperative bleeding t endency without apparent hypercoagulability signs.

• Neonatal Medicine
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• v.17 no.2
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• pp.239-244
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• 2010

Purpose: To evaluate two different heel lancet device in terms of pain response and success of the procedure in the preterm infants undergoing heel puncture. Methods: 100 preterm infants undergoing capillary blood gas analysis or capillary bilirubin monitoring underwent heel puncture, were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. Primary outcome measures included the Premature Infants Pain Profile (PIPP) score, total duration of procedure, number of heel puncture and number of bruise. The pain response was evaluated using PIPP score and the effectiveness was evaluated using three criteria: total duration of blood sampling, number of puncture, bruising of the heel or ankle. Statistical analysis was performed using the SPSS ver. 13.0 program. Difference between the groups were analysed with t test (continuous variables) and the Chi square test or Fisher test (categorical variables). Results: The mean PIPP score was 4.91 for the automatic lancet group compared with 5.84 for the conventional manual lancet group (P=0.0255).The number of pain scores above 7 during blood collection did not differ between two groups (P=0.2167). The procedure took less time to perform in the automatic lancet group (mean, 30.69 seconds) than in the conventional lancet group (mean, 48.92 seconds) (P<0.0001). Conclusion: This study demonstrated that the automatic lancet device causes less pain and a shorter procedure time than the conventional manual lancet in preterm infants undergoing heel puncture. On the basis of these results the automatic lancet device is very useful method for blood collection in preterm infants by heel puncture.

• Journal of dental hygiene science
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• v.8 no.3
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• pp.139-146
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• 2008

This research had the following results after analyzing the questionnaires and the survey on 51 people experienced smoking and 51 people unexperienced smoking out of patients who participated in the practice hours of Department of Dental Hygiene to study the relevance between smoking which is one of the partial factors of oral disease and oral health. 1. 78.4% of patients smoke more while drinking, which level is still high, so it threatens the oral health. 2. 22.5 % of patients had the experience of scaling within recent 1 year, which level is still low. 3. The people who experienced smoking realized the harmfulness of smoking and during the toothbrushing, the level of self-consciousness about halitosis and bleeding gum is higher than the unexperienced. 4. The frequency of smokers' toothbrushing on the average a day is lower than non-smokers. 5. Simplified oral hygiene index of men(4.98) is higher than woman(4.00) and the people experienced smoking(4.59) is higher than the unexperienced(4.18), which means that man and the person who experienced smoking has the bad oral environment.