• 보건행정학회지
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• 제15권4호
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• pp.26-45
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• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권1호
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• pp.15-29
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• 2024

A fetoscope is an optical endoscope, which is often applied in fetoscopic laser photocoagulation to treat twin-to-twin transfusion syndrome. In an operation, the clinician needs to observe the abnormal placental vessels through the endoscope, so as to guide the operation. However, low-quality imaging and narrow field of view of the fetoscope increase the difficulty of the operation. Introducing an accurate placental vessel segmentation of fetoscopic images can assist the fetoscopic laser photocoagulation and help identify the abnormal vessels. This study proposes a method to solve the above problems. A novel encoder-decoder network with a dual-path structure is proposed to segment the placental vessels in fetoscopic images. In particular, we introduce a channel attention mechanism and a continuous convolution structure to obtain multi-scale features with their weights. Moreover, a switching connection is inserted between the corresponding blocks of the two paths to strengthen their relationship. According to the results of a set of blood vessel segmentation experiments conducted on a public fetoscopic image dataset, our method has achieved higher scores than the current mainstream segmentation methods, raising the dice similarity coefficient, intersection over union, and pixel accuracy by 5.80%, 8.39% and 0.62%, respectively.

• Journal of Chest Surgery
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• 제23권2호
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• pp.268-274
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• 1990

Bleeding after cardiopulmonary bypass remains a cause for concern, requiring reexploration of the chest in approximately 3 percent of patients who have had operations on the heart. We examined the possibility that this problem might be alleviated by desmopressin acetate [DDAVP], synthetic vasopressin analogue that lacks vasoconstrictor activity. In a prospective, randomized trial, we studied the effect of intraoperative desmopressin acetate in 20 patients [the treated group 10 patients and the control group 10 patients] undergoing various cardiac operations requiring cardiopulmonary bypass. The result showed that the early postoperative [during first 24hrs] and mean postoperative blood loss [first 3 days] of the treated group were significantly reduced than the control group[447\ulcorner199ml in the treated group versus 746\ulcorner199ml in the treated group versus 746\ulcorner295 ml in the control group, p=0.014; mean\ulcornerstandard deviation and 675\ulcorner276 ml in the treated group versus 1006\ulcorner303 ml in control group, p=0.019]. The mean red-cell transfusion in first 3days were reduced in the treated group than the control group [3.3\ulcorner1.7 units vs 4.9\ulcorner1.7units, P=0.051]. There were no untoward side effects of desmopressin acetate. We conclude that the administration of desmopressin acetate can be recommended to reduce blood loss and blood conservation in patients undergoing cardiac operations.

• 셀메드
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• 제5권2호
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• pp.12.1-12.3
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• 2015

Adolescent menorrhagia is defined as excessive menstrual bleeding from menarche to adolescents. It is a distressing condition both for the patient as well as for her parents. If it is not managed in time itmay pose significant health problems that may leads to blood transfusion. We determined the efficacy of Geru (Red ochre) in controlling the amount and duration of blood flow in patients of Adolescent menorrhagia. This study included 40 teenage girls, who presented with heavy bleeding during menstruation to Outpatient Department, Sameena Maternity Nursing Home, Hyderabad during the year of 2013. Assessment of each case was done by history and Pictorial Blood loss Assessment Chart (PBAC) score. Geru powder was given for 2 cycles and results were assessed. The data was analyzed statistically. The mean PBAC score before treatment was $497.04{\pm}389.92$ and after trial in $1^{st}$ and $2^{nd}$ it was found to be $471.13{\pm}162.18$ and $310.13{\pm}142.15$ respectively. On basis of results it was concluded that single unani drug Geru is enough in controlling bleeding and was found effective by its astringent and styptic properties.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.208-213
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• 2023

Objectives: Orthognathic surgery is a corrective intervention for maxillofacial deformities. Bleeding is a major concern for oral and maxillofacial surgeons. Various agents, such as hemocoagulase, tranexamic acid, and aprotinin have been developed to reduce intraoperative bleeding and transfusion requirements. Therefore, in this study we aimed to investigate the effects of hemocoagulase and tranexamic acid, as well as their simultaneous use, to reduce bleeding during orthognathic surgery. Patients and Methods: This retrospective study included patients who had undergone simultaneous orthognathic surgery of the maxilla and mandible between January 2013 and September 2022 and were classified into three groups based on drugs administered: hemocoagulase (Botropase), tranexamic acid, and a combination of both drugs. We recorded patient age, sex, weight, blood loss, and duration of surgery. Red blood cell (RBC), hemoglobin, hematocrit, and platelet levels were measured before, immediately after, and one day after surgery. Results: No statistically significant differences were found in blood loss, RBC, hemoglobin, hematocrit, or platelet levels between any of the groups. There were no differences in the drug effects between Le Fort I and bilateral mandibular sagittal split osteotomies, with or without double genioplasty. However, there were significant reductions in RBC, hemoglobin, hematocrit, and platelet levels during genioplasty. Conclusion: Tranexamic acid, hemocoagulase, and their combination had similar efficacy in patients who underwent Le Fort I and bilateral mandibular sagittal split osteotomies with and without genioplasty.

• 대한장애인치과학회지
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• 제9권2호
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• pp.98-102
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• 2013

본 증례에서는 재생불량성 빈혈 환자의 치료에 있어 감염 가능성과 출혈 가능성을 고려하였으며 의과적 관리와 병행한 치과 치료를 성공적으로 시행하였다. 재생불량성 빈혈 환자의 사망원인은 감염과 출혈이 주를 이루므로 치과의사는 치료하기 전 이와 관련된 혈핵학적 특성을 알아야 하며, 가능한 치과 치료의 범위와 개입 시기를 이에 기반을 두어 판단하여야 한다. 치과 치료 전 혈소판 수치와 절대 호중구수를 고려하여 수혈과 예방적 항생제의 필요 여부를 결정하여야 할 것이다. 또한, 이러한 환자에 있어 예방치료와 구강 위생 관리는 일반 환자에서 중요하다. 주기적 검진 및 구강 위생에 대한 교육이 보다 강조되어야 할 것이다.

• 대한암한의학회지
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• 제14권1호
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• pp.29-35
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• 2009

Approximately 10 percent of advanced stomach cancer patients have internal bleeding in their stomach. It is crucial to treat internal bleeding since it severely deteriorates patient's condition, and disturbs process of chemotherapy. There are hemostatic agents and dressing, radiotherapy, endoscopic ligation and coagulation, surgical methods to treat bleeding. However, these methods cannot be executed in some cases in which patient is in terminal stage or not in desirable condition to take these treatments. We are going to introduce a case of advanced gastric cancer patient having stomach bleeding who made a choice to take oriental medical treatments. The patient was on third stage of stomach cancer, had 3200cc of blood transfusion for five times. After diagnosed as not being able to have resection, he started to oriental medical treatments to stop bleeding. From March 28, 2009 to April 16, 2009, we administer 120cc Bojungikgi-tang gamibang to the patient in 90minutes after each meal. During 19days of having Bojungikgi-tang gamibang, we observed that the patient needed significantly lower amount blood transfusion, to 640cc. The patient improves in performance, and was able to eat more. Despite of short period of observation, this case indicates that Bojungikgi-tang gamibang treatment to the patient could work as hemostat, further improved quality of patient's life.

• 한국임상수의학회지
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• 제30권5호
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• pp.359-362
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• 2013

6살령의 중성화된 숫컷 말티즈(4.16 kg)가 2일전 스켈링과 발치를 실시한 후 지속적인 구강내 출혈로 본원에 내원하였다. 환축은 폰 빌레브란트 인자 항원 평가 결과 54% (정상 범위 70%에서 180%)였으며, 유전된 폰 빌레브란트병를 가진 동형접합체로 판정되었다. 초기 치료를 위해 신선 전혈 수혈을 실시하였다. 수혈 후 환축은 임상증상이 개선되었으며 현재까지 건강한 상태이다. 본 증례는 한국내 말티즈에서 발생한 제 1형 폰 빌레브란트병의 첫 번째 진단 보고이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.276-280
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• 2016

Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the stomach, which were treated with an epinephrine injection. The Dieulafoy lesion, although thought to be rare, should be considered when investigating an acute gastrointestinal bleed. These lesions have been successfully treated endoscopically. Appropriate anticipation and preparation for diagnosis and therapy can lead to optimal outcomes for the pediatric patient.

• Pediatric Infection and Vaccine
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• 제5권1호
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• pp.143-146
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• 1998

Syphilis is a systemic communicable disease caused by the motile spirochete, Treponema pallidum, which is only a natural pathogen for human. The distribution and trends of syphilis are influenced by biologic factors, sexual behaviors, biomedical technology, availability of and access to health care, public health efforts, changes in population dynamics, and sociocultural factors. Although sexual contact is the main route of transmission, Treponema pallidum may also be infected through direct contact with syphilitic lesions, blood transfusion, ingestion of menstrual blood or vaginal secretions, or transplacental transmissions. In extremely unusual circumstances, infection by means of contact with a skin lesion and human bite have been reported. We experienced a case of syphilis which is thought to be infected by the abnormal imposition of hands on a child, which caused unnecessary erosive trauma with fingernails.