• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.6-12
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• 2009

Background: The efficacy of several thrombolytic agents for treating massive pulmonary thromboembolism (PTE) has been reported to be similar. However, the difference of the bleeding complications caused by two commonly used thrombolytic agents in PTE patients is not well known. The aim of this study was to compare the therapeutic efficacy and the bleeding complications between urokinase and recombinant tissue-type plasminogen activatior (rt-PA, alteplase) in a Korean medical center. Methods: We retrospectively reviewed the clinical data of the patients who were treated with thrombolytic agents (urokinase and alteplase) because of massive PTE. Results: A total of 40 patients were included: 16 (40%) treated with urokinase and 24 (60%) with alteplase. The patients treated with alteplase showed a shorter duration of using vasopressor agents than did the patients who were given urokinase, but the duration of mechanical ventilation, the length of the ICU stay and the hospital stay were not different between the thrombolytic agents. Five patients treated with urokinase and eight patients treated with alteplase died (p=0.565): One patient in the urokinase group and four patients in the alteplase group died due to pulmonary thromboembolism. Bleeding complications after thrombolysis were observed in 3 patients (7.5%) treated with urokinase and in 11 (27.5%) patients treated with alteplase (p=0.079). Major bleeding complication occurred in 2 patients who were treated with alteplase. Conclusion: Urokinase seems to have fewer bleeding complications with an equivalent efficacy, as compared to alteplase, in Korean patients who suffer with massive pulmonary thromboembolism.

• The Journal of Pediatrics of Korean Medicine
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• v.26 no.3
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• pp.55-63
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• 2012

Objectives The causes of Epistaxis could vary in children, but among them, digestive problem is an important cause. So, the purpose of this study is to report seven cases of chronic epistaxis treated by oriental medicine. Methods The seven patients who are diagnosed with epistaxis were treated with herbal medicine (Auajinuktang-gamibang), and its effect was measured. Results After the treatment, number of the epistaxis incident is decreased, and the patient's general conditions have gotten better. Conclusions This study has shown that oriental medical treatment on children's epistaxis was effective, but further studies are needed.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.2
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• pp.51-54
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• 2013

A 30-year-old man with morbid obesity (height: 176 cm, body weight: 100 kg, body mass index: 32.28) was scheduled for reconstruction of the mandibular fracture. During induction of general anesthesia and nasotracheal intubation, we experienced massive epistaxis, hypoxemia and difficult airway management. Fortunately, we performed oro-tracheal intubation with direct laryngoscopy and it barely succeeded. He recovered without any residual complications and rescheduled seven days later and we successfully performed awake fiberoptic nasotracheal intubation. The patient discharged on the fourth postoperative day.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.118-124
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• 2001

배경: 승모판막재건술이 승모판막치환술보다 술후 좌심실기능이 보다 향상될 수 있으며 또한 수술사망율과 인공판막에 관련된 합병즈인 혈전색전증, 심내막염 및 항응고제사용에 따른 출혈빈도는 낮다고 하였다. 방법: 1996년 1월부터 2000년 5월까지 승모판막폐쇄부전으로 진단된 환자 87례를 대상으로 재건술군 59례, 치환술군 28례로 나누어 비교분석하였다. 결과: 술전 환자들의 NYHA 기능분류, 흉부 X-선상 심흉곽의 비, 심초음파상 좌심실박출계수는 두 군간에 유의한 차이가 없었다. 원인질환은 양군에서 퇴행성 병변이 가장 많았다. 체외순환시간은 재건술군에서 유의하게 길었으나 수술사망은 양군에서 없었다. 술후 NYHA 기능분류, 흉부 X-선상 심흉곽의 비는 향상되었으나 두 군간에 차이가 없었으며 술후 좌심실박출계수는 두 군에서 감소되었으나 유의한 차이는 없었다. 결론: 이상의 결과로 승모판막폐쇄부전에 대하여 재건술이 치환술처럼 비교적 안전하게 시행될 수 있는 술식으로 사료된다.

• The Journal of Internal Korean Medicine
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• v.12 no.1
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• pp.45-55
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• 1991

It has been known that the nosebleeding is a king hemorrhage occured to be damaged yang-rak (陽略) & lung. the results obtained were as follows; 1. The cause of nosebleeding were divided internal external, these were lung-heat(肺實熱), wind-heat(風熱), dry-heat(煥熱), wind-cold(風寒), summer-heat(暑熱), and those were transporting of Liver-fire(肝火犯肺), Liver-kidney-fire(肝腎陰虛熱傷肺), Stomach-fire(胃火熾盛), Heart-fire(心火千肺). 2. The treatment of external ; Chungpaesulyul(淸肺泄熱), Yanghyuljihyul(凉血止血), Sanpungchungyul(散風淸熱), Jaeumchungjo(滋陰淸煥). 3. The treatment of internal ; Chungkansahwa(淸肝瀉火), Yanghuljihyul(凉血止血), Jayumganghwa(滋陰降火), Chunguysahwa(淸胃瀉火). The cause of nosebleeding was almost heat (fire), and the treatment were Sanpyo(散表) & Chungri(淸裏).

• Proceedings of the KAIS Fall Conference
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• 2011.12a
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• pp.334-337
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• 2011

본 연구는 항문질환 발생과 생활습관 양상과의 관련요인을 파악하기 위해 환자-대조군 연구를 시도하였다. 자료수집은 2011년 1월 10일부터 2011년 2월 28일까지 서울에 소재한 종합병원 외과에 내원한 항문질환을 있는 환자군 86명과 항문질환 병력이 없는 대조군 338명을 선정하여 설문 및 면접조사를 하였다. 연구결과는 첫째, 심신저하상태는 환자군에서 약간저하가 67.4%로 대조군의 50.6% 보다 유의하게 높은 것으로 나타났다($X^2$=10.75, p<.05). 둘째, 항문출혈이 있는 경우가 없는 경우에 비해 항문질환 발생 비차비는 2.85(OR=2.85, 95% CI=1.41-5.48)이었다. 이러한 결과를 토대로 배변시 심리적으로 편안함을 느낄 수 있도록 하고 개인의 규칙적인 배변습관을 갖도록 하는 것이 항문질환 발생 및 재발을 감소시킬 것으로 본다.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.121-123
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• 2012

Nasotracheal intubation is an essential procedure during general anesthesia for dental treatment. Fiberoptic intubation is best accomplished by those who perform it as part of their daily practice. But nasal approach of fiberoptic intubation has some complications such as epistaxis and laryngeal injury. Especially, epistaxis is common and it make fiberoptic intubation because of limited view. When the epistaxis obstruct the field of vision we have to withdraw the fiberoptic bronchoscope and consider the other method for securing the airway. We succeeded in securing the airway of patient who had epistaxis during the fiberoptic nasotracheal intubation without withdrawing the fiberoptic bronchoscope. We used blind intubation guided by light source placed the tip of fiberoptic bronchscope applied to lightwand intubation.

• Journal of Rhinology
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• v.25 no.2
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• pp.118-122
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• 2018

Epithelioid hemangioendothelioma is a rare vascular tumor with intermediate malignity and metastasis risk. It presents epithelioid cells with intracytoplasmic vacuoles and low mitotic activity. Its vascular nature can be confirmed by immunohistochemical studies (vimentin, CD31, CD34, and factor VIII). It is extremely rare in the nasal cavity, with only one case reported on the middle turbinate in Korea. The authors present a case of epithelioid hemangioendothelioma on the choana with a size of 2mm, which easily coult have been misdiagnosed as a blood clot.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.953-959
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• 2005

Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.97-102
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• 2012

High-resolution carotid MRI allows visualization of carotid atherosclerotic plaque characteristics. MRI serves as a noninvasive option for the detection of active plaque inflammation and intraplaque hemorrhage. Significant gains in signal-tonoise ratio and contrast-to-noise ratio can be obtained for carotid atheroma imaging at 3T compared with 1.5T. Normalized wall index or wall area on MRI has shown its efficacy in monitoring the response after medical therapy. $T(2)^*$ quantification in carotid plaques before and after the administration of ultrasmall superparamagnetic iron oxide particles shows difference in response to treatment according to drug doses. In conclusion, high-resolution MRI is useful in the diagnosis and monitoring of carotid atherosclerotic plaques prone to transient ischemic attack and stroke.