• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.28-30
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• 2016

Major maxillofacial bone injury itself can be life threatening from both cardiovascular point of view, as well as airway obstruction. Significant hemorrhage from facial fracture is an uncommon occurrence, and there is little in the literature to guide the management of these patients. We report a 73-year-old male driver who was transported to our hospital after a motor vehicle collision. The patient was hypotensive and tachycardic at presentation and required active fluid resuscitation and transfusion. The patient was intubated to protect the airway. All external attempts to control the bleeding, from packing to fracture reduction, were unsuccessful. Emergency angiogram revealed the bleeding to originate from terminal branches of the sphenopalatine artery, which were embolized. This was associated with cessation of bleeding and stabilization of vital signs. Despite the age and severity of injury, the patient recovered well and was discharged home at 3 months with full employment. In facial trauma patients with intractable bleeding, transcatheter arterial embolization should be considered early in the course of management to decrease mortality rate.

• Journal of Trauma and Injury
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• v.27 no.2
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• pp.29-32
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• 2014

Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.

• Proceedings of the IEEK Conference
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• 2009.05a
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• pp.138-140
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• 2009

Hemorrhage shock occupies high rate in trauma patient's mortality and blood pressure is the variance that judges early diagnosis and the effect of remedy. Systolic blood pressure is related to pulse transit time(PTT). PTT means the time that is required to flow from the heart to peripheral artery. PTT is influenced from the length, cross section and stiffness of the blood vessels. It is hard to evaluate the correlation between systolic blood pressure and PTT because they are variable in human body. In this paper, we evaluated the correlation between the systolic blood pressure and PTT in normal and hemorrhage states using standardized rat. PTT is defined as the time differences between the R peak and the peak of pulse wave. The analyzed time differences of ECG and blood pressure are analyzed every 5minutes for 30 seconds when there is before and after bleeding. Before bleeding, systolic blood pressure and PTT are steadily preserved but when the bleeding comes started, systolic blood pressure is declined. However PTT was increased and decreased. Under the circumstance that the standardized rat is controlled by age, the length of the blood vessels, and any disease, it shows that PTT measurement using systolic blood pressure of bleeding is impossible.

• Journal of the Korea Concrete Institute
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• v.22 no.4
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• pp.559-566
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• 2010

Fifteen lightweight concrete mixes were tested to evaluate the effect of maximum size of coarse aggregate and the replacement level of natural sand on the various properties of fresh lightweight concrete. The different properties, such as water absorption against the elapsed time, pore size distribution and micro-structure of lightweight aggregates used, influencing on the workability of fresh concrete were also measured. Test results showed that the initial slump of lightweight concrete decreased with the increase of the replacement level of natural sand. The slump of all-lightweight concrete sharply decreased by around 80% of the initial slump after 30~60 minutes. The air content and bleeding rate of lightweight concrete were significantly affected by the replacement level of natural sand as well as the maximum size of coarse aggregates. Empirical equations recommended in ACI 211 and Korea concrete standard specifications underestimated the air content of the lightweight concrete, indicating that the underestimation increases with the decrease of the replacement level of natural sand. In addition, equations to predict the air content and bleeding rate of lightweight concrete were proposed based on the test results.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4971-4975
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• 2015

Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.206-212
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• 2023

Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.167-173
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• 1980

From 1976 through June 1980, 75 patients underwent Open heart operation at Korea University Hospital.Of the 75 patients, 39 were congenital heart cases and 36 were acquired heart disease cases. 39 cases of congenital heart disease were consisting of 16 T.O.F.,4 A.S.D., 10 V.S.D., 3 P.S., 1 P.D.A., 1 V.S.D. + Mi, 1 Truncus arteriosus, 1 Ebstein, 1 D.C.R.V., 1 Single ventricle. Among 36 valvular replacement cases, 18 cases of MVR, 3 cases of AVR, 6 cases of Double valve replacement, and 10 cases of Open Mitral commissurotomy, were performed. Postoperative mortality rate of congenital heart disease was 25.6% and that of acquired heart disease was 8.3%. Overall mortality rate of open heart surgery was 17.3%. Among 16 cases of postoperative death cases, 5 cases of autopsy were performed. Postoperative cause of death of our series were intracranial bleeding, pacemaker failure, low output syndrome, protamine anaphylaxis, bleeding, prosthetic valve embolism, C V A, miliary tuberculosis, hypothermia due to pump failure.

• Journal of Korean society of Dental Hygiene
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• v.16 no.4
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• pp.567-575
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• 2016

Objectives: The purpose of the study was to investigate dental care effects of periodontal diseases patients with systemic diseases. Methods: The study subjects were ten patients. The study consisted of direct examination and interview survey. Direct examination comprised pocket depth, bleeding on the brush, O'Leary plaque record, salivary flow rate, and oral bacterial culture for three months. Results: The number of diabetic patients was eight. Four patients xerostomia and one of them had 0.7 mL per minute of salivary flow rate, decreased O'Leary plaque record, and bleeding in the brush. Those who received education were able to take control of plaque management. They recognized the need for oral care and had good self-management of oral care skills. Conclusions: The professional dental care and oral health education improved periodontal health and self-management skills of plaque in periodontal disease patients with systemic diseases.

• Proceedings of the Korea Concrete Institute Conference
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• 2001.11a
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• pp.99-104
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• 2001

Slag product has the possibility as alternative aggregate and sand under the circumstance of natural resource shortage. Copper slag is the by-product produced in process of copper industry. Recycling the slag in construction industry could give positive effects on the environmental preservation. This study presents that the fundamental properties of high strength concrete which used copper slag as alternative sand. Testing factors are concrete's slump, bleeding, air contents and compressive strength. The results of this study are as follows. (1) Mixing of W/C 30%, substitution rate 25% shows the best slump. As substitution rates are going up, concrete slump is uprising and air contents are downsizing. (2) The bleeding of concrete becomes more serious as substitution rates are going up. (3) The best compressive strength of copper slag concrete is achieved in mixing of W/C 30%, substitution rate 25%.

• Journal of Veterinary Clinics
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• v.14 no.1
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• pp.118-122
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• 1997

The lateral hoof of right hind limb of a pregnant Masai giraffe was accidentally injured, and its coronet, hoof wall, and sole were detached in a mass. The bleeding was observed from the exposed dermis of the affected foot for several hours, with second scoreof supporting lameness. The bleeding from the digital artery at the exposed dermis was stopped by epinephrine spray and direct pressing. Nitrofurazone ointment was topocally applied for 5 days and sxytetracycline solusion was delivered by a fluid jet in the affected hoof one month. The calf was born 5 months after the avulsion. The horn of the hoof wall was grown from the coronet to sole, and was gradually filled from the heel to the toe. The growth rate and filling rate of the hoof wall were 0.32mm and 0.54mm a day, respectively.