• 제목/요약/키워드: Bleeding Ratio

검색결과 316건 처리시간 0.025초

뇌경색 환자의 Warfarin($Coumadin^{\circledR},{\;}Warfar^{\circledR}$) 복용시 한약물이 INR에 미치는 영향 (Influence of Herbal Medicine Coadministration on the INR in Stroke Patients Taking Warfarin)

  • 김은주;이상호;김이동;윤상필;이준우;홍진우;박영민;정우상;조기호
    • 대한한의학회지
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    • 제25권2호
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    • pp.165-172
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    • 2004
  • Objectives: Warfarin is a representative anticoagulant, and it has been the preferred drug for treating thromboembolic diseases and preventing ischemic stroke. It should be administered in a delicate manner, because combined therapy with other drugs could affect the INR (International Normalized Ratio), thus bleeding tendency might occur. Interaction with herbal medicines still remains controversial. We aimed to examine the effect of herbal medicine on INR in patients being treated with warfarin. We aimed to examine the effect of herbal medicine on INR in the patients being treated with warfarin. Methods: We enrolled subjects being treated with a combined therapy of warfarin and herbal medicine from 1 October, 2002 to 20 November, 2003 at the Department of Cardiovascular & Neurologic Diseases (Stroke Center), Hospital of Oriental Medicine, Kyung Hee Medical Center. INR was monitored per 1 to 2 weeks and the significance of change was examined by Wilcoxon signed rank test or repeated measure analysis Results: Eighty-three subjects were included in the final analysis. As a whole, their INR was not significantly changed. There were only 9 cases in which INR changed more than 1.0; 7 showed increasing tendency, and 2 showed decreasing tendency of INR. Among the 9 cases, only 5 were suspected to have a relation to herbal medicine. Conclusions: We suggest that there was no strong evidence that herbal medicine has an influence on INR, but there is a need to perform further evaluation on larger samples to reach a concrete conclusion.

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다발성 늑골골절 치험 100례 (Multiple Rib Fracture: analysis of 100 cases)

  • 이남수;정현기;손광현
    • Journal of Chest Surgery
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    • 제12권4호
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    • pp.411-417
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    • 1979
  • During the period of 4 years from August 1, 1975 to August 1, 1979, authors have experienced 100 cases of multiple rib fractures by nonpenetrating injury at Department of Thoracic Surgery, Paik Foundation Hospital in Seoul, Korea. 1. The ratio of male to female patients with multiple rib fracture was 2.6:1 with male predominance and 84% of the total cases were between 20 and 50 years of age. 2. The most common cause of multiple rib fracture was traffic accident and falls accounted for the next largest group. 3. The most common site of rib fracture was 4th rib to 7th rib level on both hemithorax [52%]. 4. Associated injuries were cerebral contusion in 26%, clavicular fracture in 22%, long bone fracture in 22%, pelvic bone fracture in 10%, and scapular fracture in 8%. 5. Early complications and/or result of the multiple rib fractures were lung contusion in 23 cases, subcutaneous emphysema in 21 cases, hemothorax in 21 cases, hemopneumothorax in 6 cases, and flail chest in 12 cases. 6. The flail chests were managed by strapping the chest with adhesive plaster, external traction of flail segment with towel clip, ventilatory assistance for marginal clinical indications, and in cases of complicated with intrathoracic hemorrhage, wire fixation of flail segment through open thoraco-tomy. 7. The principles of therapy for hemothorax and/or pneumothorax were rapid reexpansion of the lungs by thoracentesis [11%] and closed thoracostomy [22%], but open thoracotomy had to be done on 3 cases because of massive bleeding or intrapleural hematoma and diaphragmatic rupture. 8. The over all mortality was 4% [4 among 100 cases] and the cause of all deaths was head injury.

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Post-Laminectomy Kyphosis in Patients with Cervical Ossification of the Posterior Longitudinal Ligament : Does It Cause Neurological Deterioration?

  • Cho, Won-Sang;Chung, Chun-Kee;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제43권6호
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    • pp.259-264
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    • 2008
  • Objective : Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. Methods : We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. Results : The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. Conclusion : Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

Endovascular Treatment of Wide-Necked Intracranial Aneurysms Using Balloon-Assisted Technique with HyperForm Balloon

  • Youn, Sang-O;Lee, Jae-Il;Ko, Jun-Kyung;Lee, Tae-Hong;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • 제48권3호
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    • pp.207-212
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    • 2010
  • Objective : To assess the feasibility, safety, and effectiveness of the balloon-assisted technique with HyperForm balloon in the endovascular treatment of wide-necked intracranial aneurysms. Methods : A total of 34 patients with 34 wide-necked intracranial aneurysms were treated with endovascular coil embolization using balloon-assisted technique with Hyperform balloon. Twenty-nine aneurysms (85.3%) were located in the anterior circulation. The group of patients was comprised of 16 men and 18 women, aged 33 to 72 years (mean : 60.6 years). The size of aneurysms was in the range of 2.0 to 22.0 mm (mean 5.5 mm) and one of neck was 2.0 to 11.9 mm (mean 3.8 mm). The dome to neck ratio was ranged from 0.83 to 1.43 (1.15). Sixteen patients were treated for unruptured aneurysms and the remaining 18 presented with a subarachnoid hemorrhage. Results : In the 34 aneurysms treated by the remodeling technique with HyperForm balloon, immediate angiographic results consisted of total occlusion in 31 cases (91.2%) and partial occlusion in three cases (8.8%). There were five procedure-related complications (14.7%), including two coil protrusions and three thromboembolisms; Except one patient, all were successfully resolved without permanent neurologic deficit. No new bleeding occurred during the follow-up. Twenty patients (59%) underwent angiographic follow-up from 2 to 33 months (mean 9.2 months) after treatment. Focal recanalization with coil compaction of the neck portion was observed in 5 cases (25%). Only one case showed major recanalization and underwent stent-assisted coil embolization. Conclusion : The balloon-assisted technique with Hyperform balloon is a feasible, safe, and effective endovascular treatment of wide-necked cerebral aneurysms.

재생 굵은골재와 제강슬래그 잔골재를 사용한 재생 콘크리트의 특성에 관한 실험적 연구 (Experimental Study on the Properties of Recycled Concrete using Recycled Coarse Aggregates and Steel Slag Fine Aggregates)

  • 이재승;나옥빈
    • 자원리싸이클링
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    • 제24권5호
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    • pp.63-71
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    • 2015
  • 본 연구는 재생 굵은골재와 산업부산물인 급냉 제강슬래그 잔골재를 이용한 친환경 재생 콘크리트의 재료적 특성을 파악하고 적정 혼합비를 도출하는데 그 목적이 있다. 이를 위해서 재생 굵은골재의 치환율은 30%에서 50%까지 증가시켰으며, 급냉 제강슬래그 잔골재는 10%에서 50%까지 증가시켜서 물성실험을 수행하였다. 그 결과, 재생골재의 치환율이 증가함에 따라 강도가 감소하였으나 급냉 제강슬래그 잔골재의 혼입율을 증가함에 따라 강도가 증가됨을 알 수 있었다. 더불어 급냉 제강슬래그 잔골재의 적정 치환율은 압축강도 및 탄성계수 등을 고려했을때 20~30%로 판단되며, 재생 굵은골재의 치환율 증가에도 도움이 될 것으로 사료된다.

Open thoracotomy drainage 를 받은 농흉환자의 임상적 고찰 (Clinical Evaluation of Empyema Treated by Open Thoracotomy Drainage)

  • 한영숙;김세화;이홍균
    • Journal of Chest Surgery
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    • 제11권1호
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    • pp.35-41
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    • 1978
  • After the advent of the effective antimicrobial drugs, empyema of the pleural cavity came to be considered an infrequent disease. However, in recent years the problem of empyema is increasing, probably due to bacterial changes associated with the use and misuse of antimicrobials as well as alterations in the host associated with increased longevity and chronic disease. During the 10 years period from 1957, Sop. to 1977, Aug., we experienced 152 cases of empyema, of which 37 were scheduled on open thoracotomy drainge for chronic empyema. 1. The ratio of male to female was 3.6:1 with male predominance and 64% of total was above 40 years old in age distribution. 2. The cardinal symptoms were fever[70%], dyspnea[40.5%], and sputum[40.5%]. The leucocytosis were observed in 75.7% of all cases. The hemoglobin level showed subnormal in 21.6% of all cases. 3- The underlying pathology predisposing to empyema were postoperative empyema [35.1%] and tuberculosis[32.4%] in order. 4. The pathologic organisms by bacterial culture in 37 patients were Pseudomonas [24.3%], Staphylococccus [21.6%], Streptococcus [21.6%]., no growth [8. 1%] and the remainders. 5. The late results were as follow; a. Spontaneous closure was seen in 10 patients and all of them belongs to non-tuberculous group. Their mean duration was 14 months. b. Still opened are eight; 6 in tuberculous group, remainders in non-tuberculous group. c. Secondary closure was performed in 6 patients, of which 5 cases showed successful secondary closure but one failed. The mean duration from OTD to secondary closure was 46.3 days. d. Eleven patients were not followed. e. Two patients were expired; one was due to progressive cachexia and pulmonary insufficiency, the other due to gastrointestinal bleeding unrelated to empyema.

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Factors Associated with Early Adverse Events after Coronary Artery Bypass Grafting Subsequent to Percutaneous Coronary Intervention

  • Kamal, Yasser Ali;Mubarak, Yasser Shaban;Alshorbagy, Ashraf Ali
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.171-176
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    • 2016
  • Background: A previous percutaneous coronary intervention (PCI) may affect the outcomes of patients who undergo coronary artery bypass grafting (CABG). The objective of this study was to compare the early in-hospital postoperative outcomes between patients who underwent CABG with or without previous PCI. Methods: The present study included 160 patients who underwent isolated elective on-pump CABG at the department of cardiothoracic surgery, Minia University Hospital from January 2010 to December 2014. Patients who previously underwent PCI (n=38) were compared to patients who did not (n=122). Preoperative, operative, and early in-hospital postoperative data were analyzed. The end points of the study were in-hospital mortality and postoperative major adverse events. Results: Non-significant differences were found between the study groups regarding preoperative demographic data, risk factors, left ventricular ejection fraction, New York Heart Association class, EuroSCORE, the presence of left main disease, reoperation for bleeding, postoperative acute myocardial infarction, a neurological deficit, need for renal dialysis, hospital stay, and in-hospital mortality. The average time from PCI to CABG was $13.9{\pm}5.4$ years. The previous PCI group exhibited a significantly larger proportion of patients who experienced in-hospital major adverse events (15.8% vs. 2.5%, p=0.002). On multivariate analysis, only previous PCI was found to be a significant predictor of major adverse events (odds ratio, 0.16; 95% confidence interval, 0.03 to 0.71; p=0.01). Conclusion: Previous PCI was found to have a significant effect on the incidence of early major adverse events after CABG. Further large-scale and long-term studies are recommended.

전기로슬래그 잔골재를 사용한 콘크리트의 기초물성에 관한 실험적 연구 (The Experimental Study on the Properties on Concrete to use the Electric Arc Furnance Slag as Fine Aggregate)

  • 최성우;김정식;전준영;김은겸;류득현
    • 한국콘크리트학회:학술대회논문집
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    • 한국콘크리트학회 2008년도 추계 학술발표회 제20권2호
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    • pp.389-392
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    • 2008
  • 철강 산업에서 발생되는 슬래그 부산물 중 전기로슬래그는 슬래그 자체의 팽창반응성으로 인해 콘크리트용 원자재로서 활용이 불가능하지만, 슬래그의 팽창반응성을 제거한 전기로산화슬래그는 콘크리트용 골재로서 활용이 가능하다. 본 연구에서는 산화 전기로슬래그 잔골재를 사용한 콘크리트의 기초품질 특성을 검토한 것으로서, 산화 전기로슬래그 잔골재는 입형이 둥근 풍쇄전기로슬래그 및 입형이 부순모래와 유사한 파쇄 전기로슬래그 잔골재가 있으며, 본 실험에서는 파쇄 전기로슬래그 잔골재를 사용하였다. 잔골재에 대해 용적 대체한 경우에서의 콘크리트의 품질 특성을 검토 결과, 전기로슬래그 잔골재는 골재 자체의 밀도가 일반 천연골재에 비해 매우 높고, 흡수율이 매우 낮기 때문에 전기로슬래그 잔골재 대체율이 증가할수록 동일 유동성을 확보하는 단위수량은 감소하는 경향을 나타내고 있으며, 동일 단위수량 적용시에도 콘크리트의 강도 발현 특성은 증가하는 경향을 나타내고 있다.

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Pyogenic Granuloma: A Retrospective Analysis of Cases Treated Over a 10-Year

  • Koo, Mun Geun;Lee, Soo Hyang;Han, So Eun
    • 대한두개안면성형외과학회지
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    • 제18권1호
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    • pp.16-20
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    • 2017
  • Background: Pyogenic granuloma (PG) is a benign vascular lesion of the mucosa and skin. Recent studies of the epidemiology of PG are rare. We aimed to retrospectively analyze characteristics of PG cases in South Korea. Methods: We reviewed the medical records of 155 patients treated for PG between March 2005 and May 2014. The male-to-female ratio was 1:1.2 (70 males, 85 females). The mean age of patients was 35.3 years. Results: A high occurrence was observed in the first and third decades in males, and the fourth to fifth decades in females. There was a statistically significant difference between genders according to age group (p<0.05). The average lesion diameter was $0.84{\pm}0.46cm$ (long axis). The most frequently involved site was the face (n=47). Bleeding was the primary complication (n=41). PG was mostly treated with excisional biopsy (n=74). The recurrence rate was 7.7% (n=12). Conclusion: We concluded that most common site of PG was the face, the age of female with PG is higher than previous studies, and finger is associated with trauma more than other sites. The most recent epidemiological information on PG of this study will support the treatment and diagnosis of PG and future research objectives.

Peri-implant crevicular fluid levels of cathepsin-K, RANKL, and OPG around standard, short, and mini dental implants after prosthodontic loading

  • Alan, Raif;Marakoglu, Ismail;Haliloglu, Seyfullah
    • Journal of Periodontal and Implant Science
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    • 제45권5호
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    • pp.169-177
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    • 2015
  • Purpose: Despite the high success rates of endosseous dental implants, their placement is restricted according to the height and volume of bone available. The use of short or mini dental implants could be one way to overcome this limitation. Thus, this study aimed to compare standard, short, and mini dental implants with regard to associated clinical parameters and peri-implant crevicular fluid (PICF) levels of cathepsin-K (CTSK), RANK ligand (RANKL), and osteoprotegerin (OPG), after prosthodontic loading. Methods: A total of 78 non-submerged implants (Euroteknika, $Aesthetica^{+2}$, Sallanches, France) were installed in 30 subjects (13 male, 17 female; range, 26-62 years) who visited the clinic of the Periodontology Department, Faculty of Dentistry, Selcuk University. Sampling and measurements were performed on the loading date (baseline) and 2, 14, and 90 days after loading. Assessment of the peri-implant status for the implant sites was performed using the pocket probing depth (PPD), modified plaque index, modified gingival index, modified sulcular bleeding index, and radiographic signs of bone loss. PICF samples collected from each implant were evaluated for CTSK, RANKL, and OPG levels using the ELISA method. Keratinized tissue and marginal bone loss (MBL) were also noted. Results: Clinical parameters statistically significantly increased in each group but did not show statistical differences between groups without PPD. Although implant groups showed a higher MBL in the upper jaw, only the standard dental group demonstrated a statistically significant difference. At 90 days, the OPG:sRANKL ratio and total amounts of CTSK for each group did not differ from baseline. Conclusions: Within the limitations of this study, both short and mini dental implants were achieving the same outcomes as the standard dental implants in the early period after loading.