• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.589-594
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• 2005

With the progress of medical treatment techniques of bleeding control, dental care of the patient with hemophilia has become more convenient. So many surgical treatments can be performed with out-patient. 2 cases of intraoral surgical treatment of children, one with hemophilia 3, sever, the other with hemophilia A, severe. While the former was treated under general anesthesia, the latter was treated under local anaesthesia. There are principles : 1. When a patient with hemophilia need dental treatment, the dentist must consult to his physician, pediatrician, or hematologist before dental treatment. 2. When the dentist make a treatment plan, there should be consideration of the general condition, cooperation of the patient and risk of the treatment needed. 3. Minimize the number of times of coming for dental treatment so that reduce the times that need replacement therapy of coagulation factor. And during the treatment, dentist should care for infection and bleeding.

• Journal of Korean Clinical Nursing Research
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• v.20 no.1
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• pp.53-63
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• 2014

Purpose: This study was conducted to investigate the relationship between drug-related knowledge, sick role behavior and quality of life of patients on wafarin therapy in an outpatient unit. Methods: The participants were 122 patients. Data were collected using a questionnaire and analyzed using t-test, ANOVA and Pearson correlation. Results: The Duration of wafarin averaged $28.80{\pm}32.99$ months, and 78.7% of participants remembered their blood coagulation value. The mean score for drug-related knowledge was 11.32 points out of a possible 13 points. Sick role behavior of the patients showed a moderate value with a mean of 49.83 points out of 68 points. The mean score for quality of life was rather low at 104.43 out of 175. Drug-related knowledge was significantly correlated to sick role behavior (r=0.39, p<.001), but the relationship between sick role behavior and quality of life was not significant. Also drug-related knowledge was not significantly correlated with quality of life. Conclusion: The resultsindicate that there is a need to enhance the level of drug-related knowledge in order to increase positive behavior as part of the sick role of these patients and thus improve quality of life.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.4
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• pp.485-489
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• 2000

A mucocele is a thin-walled, bluish, fluctuant swelling occurring just beneath the oral mucosa and filled with mucoid material. It usually results from damage to a salivary gland following which there is extravasation of mucus into the tissues, or occasionally it forms from dilatation of the duct of a salivary gland. The accepted treatment of a mucocele is excision of the sac and the associated minor salivary gland. Use of the $CO_2$ laser in oral surgery has several advantages. It is a very precise means of cutting tissue and causes little adjacent nontarget tissue damage. There is excellent coagulation of small blood vessels and consequently operative hemorrhage is greatly decreased. There is instant sterilization of the operative site, which decreases bacteremia. The operation sites were completely healed without any infection or complication and discomfort from swelling or pain was not noted in all cases throughout the healing process. In addition, following this therapy, there is little contraction or scarring.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1382-1389
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• 1997

Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases : prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.307-309
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• 1999

Warfarin-induced skin necrosis is a rare complication caused by transient hypercoagulable state. This state is a result of rapid decline of the protein C activity relative to that of coagulation factor II, IX, and X during initiation of oral anticoagulant therapy. We experienced a case of warfarin-induced skin necrosis involving both breasts in a patient who underwent double valve replacement 1 month before. Warfarin was replaced to a low- molecular weight heparin and the necrotic breast lesion was healed spontaneously. Low-dose warfarin was restarted and gradually increased, after which a low molecular weight heparin discontinued..

• Radiation Oncology Journal
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• v.20 no.4
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• pp.343-352
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• 2002

Purpose : Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. Materials and Methods : total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The Point A dose from the HDR brachytherapy was 28 Gy to 30 Gy $(4\;Gy\times7,\;or\;5\;Gy\times6)$. The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months $(12\~86\;months)$. Results : The incidence of rectal bleeding was $12.7\%$ (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was $8.5\%$. Most complications $(92.6\%)$ developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding an icruCRBED greater than 100 Gy $(19.7\%\;vs.\;4.2\%)$, an EBRT dose to the parametrium over 55 Gy $(22.1\%\;vs.\;5.1\%)$ and higher stages of III and IV $(31.8\%\;vs.\;10.5\%)$. In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was peformed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. Conclusion : Moderate and several rectal bleeding occurred in $8.5\%$ of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.

• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.212-215
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• 2008

Rectus sheath hematoma (RSH) is a rare condition that's caused by a sudden disruption of the deep epigastric vessels or direct damage to the rectus abdominis muscle. This condition is associated with old age, childbirth, abdominal surgery, severe cough, severe sneezing, anticoagulation therapy and/or coagulation disorders. RSH is characterized by abdominal pain and an abdominal mass, so that this is often misdiagnosed as a surgical condition such as appendicitis, intraabdominal abscess, torsion of the ovary and ruptured abdominal aortic aneurysm; this can lead to unnecessary surgery. Thus, we have to be cautious not to miss RSH when a patient with predisposing factors is suffered from abdominal pain and an abdominal mass. We report here on a case of rectus sheath hematoma that was induced by severe cough in a patient who was taking warfarin.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.50-54
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• 2015

Podostroma cornu-damae is a rare species of fungus belonging to the Hyocreaceae family. Its fruit body is highly toxic, as it contains trichothecene mycotoxins. The morphology is similar to that of immature Ganoderma lucidum, making identification difficult for non-experts. We experienced such a case of a 56- year-old male who picked and consumed podostroma cornu-damae, and consumed. Later that day, he developed digestive system symptoms, including nausea, vomiting, and abdominal pain. He presented to the emergency room (ER), there were no abnormal physical findings, symptoms improved after gastric lavage, and the patient voluntarily discharged himself on the same day. The following day, as the symptoms gradually deteriorated, he was admitted via the ER. He was presented with severe pancytopenia, alopecia, desquamation of skin, and acute renal failure. He recovered without any complications after conservative care, antibiotics therapy, and granulocyte colony stimulating factor administration. The most commonly reported complications of podostroma cornu-damae intoxication were reported pancytopenia, infection, disseminated intravascular coagulation, acute renal failure, etc. since Prevention is especially important because its toxicity can be lethal and there is no particular treatment to date, prevention is especially important. Promotion and education for the public are needed.

• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.474-480
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• 2008

Purpose : Stress hyperglycemia is common in critically ill adult patients. It is known as a predictor of increased mortality, and intensive insulin therapy has been shown to improve the prognosis in such patients. We have investigated the relationship between early stress hyperglycemia and clinical outcomes in preterm infants. Methods : In this study, 141 preterm infants with a gestational age of less than 30 weeks were enrolled. The hyperglycemic group was defined as that having maximum glucose of more than 150 mg/dL (n=61) during the first 48 h of life, and the non-hyperglycemic group was defined as that having maximum glucose of less than 150 mg/dL (n=80). Perinatal history, severity of illness using the Clinical Risk Index for Babies (CRIB) score, clinical outcomes, and mortality of the two groups were compared. Results : There was no significant difference in the gestational age between the two groups, but the birth weight (P<0.001) was significantly lower, and the CRIB score (P<0.001) was significantly higher in the hyperglycemic group. Disseminated intravascular coagulation (P<0.001) and clinically suspected sepsis (P=0.046) were more common in the hyperglycemic group. Mortality was markedly higher in the hyperglycemic group (11.3% vs. 41.0%, P<0.001). On performing a stepwise multiple logistic regression analysis, hyperglycemia (OR 3.787; 95% CI 1.324 to 10.829), the CRIB score (OR 1.252; 95% CI 1.047 to 1.496) and birth weight (OR 0.997; 95% CI 0.994 to 1.000) was independently associated with higher mortality. Conclusion : Stress hyperglycemia within the first 48 h of life is independently related to increased morbidity and mortality in preterm infants.

• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.272-277
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• 2008

Background: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea. We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced lung cancer. Methods: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately $-89^{\circ}C$, and the icing time was 5~20 seconds. Results: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy. Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications- one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during the cryotherapy procedure. However, these complications resolved and did not influence mortality. Conclusion: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with a central airway obstruction.