• Journal of Yeungnam Medical Science
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• 제9권2호
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• pp.407-415
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• 1992

Anti-HCV 양성인 만성간질환 환자 80명의 가족중 3가족에 걸쳐 3명이 anti-HCV 양성이었고 양성율 3.5%로서 HBsAg 양성 만성간질환 환자 60명의 가족중 40가족에서 HBsAg 양성자가 나타난 결과가 양성을 66.7%보다 월등히 낮은 수치를 보였다. 이 결과를 볼때 HCV는 HBV와는 다른 정도의 감염력을 가지거나 또는 다른 형태의 개체면역반응을 유도하여 항체 형성이 낮은 것이 아닌지 고려해 보아야겠다. 가족중 배우자나 자녀에 있어서의 감염율은 HBV와 비교될 정도는 아니었으나 anti-HCV 양성인 사람이 배우자나 자녀였으므로 향후 성적접촉이나 수직감염에 의한 감염 가능성에 관해 더욱 조사가 필요할 것으로 사료된다. 그러나 아직 HCV RNA를 직접검사하는 PCR검사가 보편화되어 있지 못하며 HCV 감염의 진단을 위한 검사법이 여러가지 난무하는 이유로 이후 정밀도가 높으며 쉽게 이용될 수 있는 HCV 감염진단을 위한 검사법이 확립되어 정확한 HCV 환자의 파악이 먼저 되어야 HCV 감염의 역학적 조사가 정확히 이루어지며 HCV 감염관리에 도움이 될 것으로 생각된다.

• 한국임상수의학회지
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• 제20권2호
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• pp.245-247
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• 2003

4년령의 잉글리시쉽독이 4일간의 호흡곤란과 비출혈로 본 건국대학교 수의과대학 동물병원에 내원하였다. 항응고제인 살서제의 섭취는 vitamine K1의 재생을 방지하여 순환 응고인자의 활성을 감소시킨다. 따라서 살서제에 중독이 되었을 때, 빠르고 적절한 치료가 수행되지 않으면 심각한 출혈로 인해 의식불명에 빠지고 심지어는 생명을 위협하기도 한다. 본 증례에서는 의식혼탁과 후궁반장의 임상증상을 보이는 4년령의 중성화된 개의 성공적인 치료를 보고하고자 한다. 적절한 수혈요법과 vitamin K1를 이용한 효과적인 치료를 실시하여 임상증상의 현저한 개선을 보였으며, 환축은 현재 완치되어 건강한 삶을 살고 있다.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.16-20
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• 2010

Purpose: High-grade (III, IV, V) renal injury may need interventional management. We investigated whether the selective embolization of the renal artery is effective for the treatment of major renal injury in comparison with emergency renal exploration. Methods: We retrospectively reviewed the medical and radiologic records of patients who underwent surgery or embolization for renal injury (Grade III, IV, V) between January 1990 and December 2007. We analyzed the change in treatment method before and after 2000, the blood pressure, the hemoglobin at the time of visit, the hospital days and the complications in patients who received surgery or embolization. Preserved renal functions of the embolized kidneys were identified by using enhanced CT. Results: Cases of surgery and embolization were 37 and 13, respectively: 5 and 4 in renal injury grade III, 17 and 6 in grade IV and 13 and 3 in grade V. Cases of surgery and embolization were 33 and 1 before 2000 and 2 and 12 after 2000, repectively: embolizations increased after 2000. No significant differences in mean diastolic pressure, hemoglobin, hospital days and complications existed between the surgery and the embolization groups (p>0.05). However, the transfusion volume was significantly smaller in the embolization group (p<0.05). One postoperative complication occurred in the surgery group. We identified the preserved renal functions of the embolized kidney by using enhanced CT. Conclusion: Embolization could be one treatment method for high-grade renal injury. Thus, we might suggest selective embolization a useful method for preserving the renal function in cases of high-grade renal injury.

• 한국응급구조학회지
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• 제10권2호
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• pp.63-76
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• 2006

This study was designed to get basic data about AIDS educational program development of students of university, especially for students of the department of Emergecy Medical Technology. The objective of this study was to identify the level of AIDS related Knowledge and Attitude of freshmen of university. The subject for this study consisted of 2022 male and female students who entered in 2005to Gongju National university in Chungnam province. Data was colledted by self-reporting questionaire consist of 66 items on 20th, February, 2005. The findings of this study can be summarized as follows. 1) The mean overall knowledge score was estimated to be 70.22%. 2) The knowledge score about definition of AIDS was high(93.2%). but knowledge score about progression and incubation period was low(48%). 3) AIDS related knowledge about diagnosis with blood was was high(91.2%), but those about period of antibody formation was relatively low(66.2%). 4) The score about latent appearance of AIDS-related symptoms was hlgh(93.7%), but those of apprehension of individual symptom was very low(57.5%). 5) Percentage of correctly answered respondent about transmission with needle and transfusion was very high(>94%), but the score of transmission through the anal and oral sex was relatively low(75-79%). 6) The knowledge score about prevention with condom was high(89.5%), but misconception of disinfection and vaccination was also high. 7) Acknowledgement about utility of consultation, information, treatment was very low (10-17%). In the end, the study concludes that it is necessary to develop comprehensive AIDS education programs to improve knowledge about the disease as well as to allay the fears and anxiety of the contact.

• Journal of Korean Biological Nursing Science
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• 제15권4호
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• pp.210-218
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• 2013

Purpose: The purpose of this study was to identify the characteristics and nursing activities of severe trauma patients regarding damaged body parts in Busan Regional Emergency Medical Center. Methods: A survey using a 'trauma patient information questionnaire and a list of nurse activities' was conducted with 133 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. The collected data were analyzed by the SPSS/WIN 12.0 program. Results: Almost all of the subjects were men, and the mean age was 48.8. The amount of road traffic accidents was 60.4%, and the mean RTS and ISS were 6.08, and 23.14 points. Nursing activities in common were airway management, assessment of LOC & GCS, and EKG monitoring. Most of head and neck trauma patients were cared for manasing using intracranial pressure: each patience had the following assessed: pupil size and light reflex, they were checked the leak of CSF, kept $30^{\circ}$ head elevation, and administered medications. Some of chest trauma patients were treated for chest tube and central venous catheter insertion. Partial abdominal trauma patients were administered analgesic and cared for using arterial pressure measurement. Part of the limbs and pelvis trauma patients were given a blood transfusion. Conclusion: Based on the results, the characteristics and nursing activities were specific according to the specific damaged body parts.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1649-1654
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• 2014

Background: Clinically significant portal hypertension (PHT) is considered as a contraindication for hepatectomy according to the guidelines of the European Association for Study of Liver and the American Association for Study of Liver Diseases. However, this issue remains controversial. Here we performed a metaanalysis to evaluate the impact of PHT on the results of hepatectomy for hepatocellular carcinoma (HCC). Methods: Cohort studies evaluating the impact of clinically significant PHT, defined as oesophageal varices and/or splenomegaly associated with thrombocytopenia, on the results of hepatectomy for HCC were identified using a predefined search strategy. Summary risk ratios (RRs) and 95% confidence intervals (95% CIs) for PHT and outcomes after hepatectomy for HCC were calculated. Results: Seven cohort studies which including 574 cases with PHT and 1,354 cases without PHT were considered eligible for inclusion. The meta-analysis showed that, in all patients, pooled RRs of post-operative liver failure, post-operative ascites, peri-operative blood transfusion, operative mortality, 3- and 5-year overall survival associated with PHT were 2.23 (95% CI: 1.48-3.34, P=0.0001), 1.77 (95% CI: 1.19-2.64, P=0.005), 1.23 (95% CI: 1.03-1.49, P=0.03), 2.58 (95% CI: 1.12-5.96, P=0.03), 0.82 (95% CI: 0.75-0.88, P<0.00001) and 0.76 (95% CI: 0.69-0.85, P<0.00001), respectively. In subgroup analysis, similar results were found in Child-Pugh class A patients. Conclusion: This meta-analysis suggests that presence of oesophageal varices and/or splenomegaly associated with thrombocytopenia is associated with higher rates of post-operative complications and poor long-term survival after hepatectomy for HCC.

• 대한기관식도과학회지
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• 제15권2호
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• pp.36-41
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• 2009

Background : Controversy exists whether patients with esophageal carcinoma are best managed with classical Ivor Lewis esophagectomy(ILO) as combined thoracic and abdominal approach or transhiatal esophagectomy(THO). The THO approach is known to be superior with respect to operative time, morbidity and mortality, and length of stay, especially at poor pulmonary function patient, but may represent an inferior cancer operation due to inadequate mediastinal clearance compared with ILO. Accordingly, we estimated the THO role at esophageal cancer to compare each operative approach. Material and Method : From January 2002 to December 2007, we performed a retrospective review of all esophagectomies performed at Keimyung University Dongsan Medical Center; 36 underwent THO, and 11 underwent ILO. Result : There were all men and squamous cell carcinoma but 1 woman at ILO group, 2 women at THO group. There were no significant differences between THO and ILO with age, sex, location of tumor, mean tumor length. There were significant differences at preoperative pulmonary function test(In ILO group, average FEV1 is $2.65{\pm}0.6\;L/min$ and iIn THO group, average FEV1 is $2.07{\pm}0.7\;L/min$). The amount of blood transfusion, hospital stay, leak rates and respiratory complication, hospital mortality rate were not significantly different. Conclusion : There was no significant difference in the post-operative complication, hospital mortality rate, long-term survival of patients of both operative method. THO method had lower mobidity and mortality at poor pulmonary function patient than ILO method. Hence, THO is a valid alternative to ILO for patients with poor general condition or expected post-operative respiratory complication.

• 대한두경부종양학회지
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• 제12권2호
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• pp.224-229
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• 1996

Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.238-241
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• 2017

A 52-year-old man experienced blunt trauma upon falling from a height of 40 m while trying to repair the elevator. The patient's systolic blood pressure and hemoglobin levels were 60 mmHg and 7.0 g/dL, respectively, upon admission. A large volume of bloody discharge was observed in the open wound of the perianal area and sacrum. A computed tomography scan revealed an open comminuted sacral fracture with multiple contrast blushes. He underwent emergency laparotomy. Both internal iliac artery ligations were performed to control bleeding from the pelvis. Protective sigmoid loop colostomy was performed because of massive injury to the anal sphincters and pelvis. Pad packing was performed for a sacral open wound and perineal wound at the prone position. After resuscitation of massive transfusion, he underwent the second operation 2 days after the first operation. The pad was removed and the perineal and sacral open wounds were closed. After the damage-control surgery, he recovered safely. In this case, the hemodynamically unstable, open comminuted sacral fracture was treated safely by internal iliac artery ligation with pad packing.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.21-24
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• 2013

Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-$Di^a$Dia antibody rarely occurs. The anti-$Di^a$ antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the $Di^a$ antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-$Di^a$ antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-$Di^a$ antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-$Di^a$ antibody identification test is recommended due to the suspicion of an anti-$Di^a$ antigen, followed by early administration of intravenous immunoglobulin.