• Title/Summary/Keyword: Current Bleeding

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Total anomalous pulmonary venous connection (supracardiac type: report of 3 cases) (심장상부 환류형 총폐정맥환류이상증의 수술치험 3례 보고)

  • 김은기
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.322-330
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    • 1983
  • TAPVC represents 1 to 4% of all congenital cardiac defects. Generally severe and refractory cardiac failure develops in the majority of patients in the early infancy. In a small minority of patient, they are relatively asymptomatic in infancy, but symptoms will develop of necessity In the later life. Our three cases had dyspnea on exertion and cyanosis and had a history of frequent respiratory infections. All 3 cases had the typical showman configuration on roentgenograms of the chest. Current surgical therapy has greatly altered the unfavorable course of these patients after institution of extra-corporeal circulation. We have experienced three cases from June, 1973 to May, 1983, the patients were undergone complete repair with extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery in the Yonsei University. The ages ranged from 12 years to 14 years, all cases were supracardiac type of TAPVC. Only one case died due to bleeding from anastomosis site between LA and pulmonary venous trunk. In the remaining two patients with complete corrections of TAPVC, there was excellent relief of symptoms such as dyspnea and cyanosis. Their postoperative course have been good during follow-up.

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The Evaluation of Therapeutic Control with Warfarin in Patients with Mechanical Heart Valve Prostheses (인공심장판막 환자를 대상으로 한 Warfarin 치료의 적정성 평가)

  • Im, Young Sun;Chang, Byung Chul;Suh, Ok Kyung;Lee, Suk Hyang;Shin, Hyun Taek
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.1
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    • pp.27-34
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    • 1999
  • The goal of oral anticoagulation therapy with warfarin is to maintain INR values within the therapeutic range in order to prevent complications such as bleeding and thrombosis. The purposes of this study were to investigate the current level of anticoagulation control using INR values, to investigate the incidences of thromboembolism and bleeding complications, and to compare the effect of low intensity INR regimen with therapeutic range recommended by ACCP (American College of Chest Physician). Two hundred three patients with mechanical heart valve replacement done at Yonsei University Cardiovascular Center between January 1994 and December 1996 were selected and reviewed retrospectively. The target INR ranges of $2.5\sim3.5$ (ACCP standard) and low intensity INR of $2.0\sim3.5$ were used for evaluation. According to ACCP standard, $51.2\%$ of patients and $31.1\%$ of INR values were within the therapeutic range when average INR and cumulative INR were used, respectively. Applying low intensity INR values of $2.0\sim3.5$, the therapeutic control was achieved in $57.4\%\;and\;90.1\%$, using average INR and total INR, respectively. The incidences of major and minor bleedings were $0.5\%\;and\;26.6\%$, respectively. The incidence of thromboembolism was $0.5\%$. There was no significant difference in terms of complication incidences between INR $2.0\sim2.5\;and\;INR\;2.5\sim3.5$ groups. However, INR values at the time of bleeding were generally high. In conclusion, the evaluation of patients with mechanical heart valve replacement showed low level of therapeutic control with warfarin therapy. This is partially explained by the fact that the physicians at Yonsei University Cardiovascular Center were using lower intensity INR values as a goal than recommended INR. Also, in the near future, systematic anticoagulation service should be implemented at various hospitals in Korea so that patients on anticoagulant therapy can be more closely monitored to be within the recommended INR by ACCP.

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Study on Material Segregation of Grout and Filling Characteristic of Grouting for Post-Tensioned Concrete Beam (PC 그라우트의 재료분리 및 PC 빔 그라우팅 충전성에 관한 연구)

  • Lee, Jun-Ki;Choi, Joon-Ho;Yoon, Jeong-Seob;Cho, In-Sung
    • Journal of the Korea Concrete Institute
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    • v.22 no.3
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    • pp.419-426
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    • 2010
  • This paper discusses a series of experiments including material improvement in order to ensure quality of grouting for the post-tensioned structure. In presstressed concrete, grouting refers to the construction procedure of filling empty space of duct enclosing the prestress tendons using cementitious material, To date, adequate quality control of the grouting has not been established in Korea because the relationship between the grouting and durability of post-tensioned structure is not well-recognized. The Korean standard does not consider the important material characteristic, wick effect, which is caused by tendons in the ducts, and furthermore current standard testing method does not quantify reasonable material segregation. As a result, the grout material, which satisfies the current material standards, may well exhibit excessive bleeding of water or shrinkage during construction. In this study, international codes and standards related to grouting were surveyed. The mix proportions of the constituents and novel admixtures were suggested to meet equivalently with these standards. Performance of this enhanced grout was compared with common domestic grouts using the international standard testing method. A series of mock-up specimens considering geometry of PC beam was constructed and grout flow pattern was observed as the grout was injected. It was observed that the grouting performance was highly influenced by material properties and filling characteristic can be varied depending on geometry of ducts.

Design of a Fully Integrated Low Power CMOS RF Tuner Chip for Band-III T-DMB/DAB Mobile TV Applications (Band-III T-DMB/DAB 모바일 TV용 저전력 CMOS RF 튜너 칩 설계)

  • Kim, Seong-Do;Oh, Seung-Hyeub
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.21 no.4
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    • pp.443-451
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    • 2010
  • This paper describes a fully integrated CMOS low-IF mobile-TV RF tuner for Band-III T-DMB/DAB applications. All functional blocks such as low noise amplifier, mixers, variable gain amplifiers, channel filter, phase locked loop, voltage controlled oscillator and PLL loop filter are integrated. The gain of LNA can be controlled from -10 dB to +15 dB with 4-step resolutions. This provides a high signal-to-noise ratio and high linearity performance at a certain power level of RF input because LNA has a small gain variance. For further improving the linearity and noise performance we have proposed the RF VGA exploiting Schmoock's technique and the mixer with current bleeding, which injects directly the charges to the transconductance stage. The chip is fabricated in a 0.18 um mixed signal CMOS process. The measured gain range of the receiver is -25~+88 dB, the overall noise figure(NF) is 4.02~5.13 dB over the whole T-DMB band of 174~240 MHz, and the measured IIP3 is +2.3 dBm at low gain mode. The tuner rejects the image signal over maximum 63.4 dB. The power consumption is 54 mW at 1.8 V supply voltage. The chip area is $3.0{\times}2.5mm^2$.

Truncus Arteriosus -Report of a Case- (동맥간(動脈幹) 1례(例) 보고(報告))

  • Hong, Jang Soo;Park, Joo Chul;Rho, Joon Ryang;Kim, Chong Whan;Suh, Kyung Phil;Lee, Yung-Kyoon
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.271-275
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    • 1976
  • Truncus arteriosus is a rare and highly lethal cardiac anomaly characterized by a single arterial trunk emerging from the heart and supplying the coronary, systemic, and pulmonary circulations, The first successful correction of truncus arteriosus was reported by McGoon et al. in 1968 and was based on experimental work reported by Rastelli et al. in 1967 in which a conduit consisting of a homograft of the ascending aorta and aortic valve was used to establish continuity between the right ventricle and the pulmonary arteries, Modification of this procedure using a Dacron tube valved with porcine xenograft instead of a homograft have resulted in the current definite treatment for truncus arteriosus. This report describes an 3 years and 4 months old boy with heart failure from type I truncus arteriosus who was diagnosed as the V. S. D. with pulmonary hypertension preoperatively and underwent corrective surgery employing the Rastelli procedure using a Dacron conduit valved with canine xenograft, but died due to massive bleeding from the anastomosis sites in operating room.

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Surgical treatment of Truncus Arteriosus (동맥간의 외과적 치료)

  • 전태국
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.143-152
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    • 1991
  • From 1983, until June, 1990, 10 patients with various type of truncus arteriosus underwent total surgical correction including Rastelli procedure at Seoul National University Hospital. The age at operation ranged from 1 month to 9 years [mean 2.1 years]. Six patients had truncus type I, 3 patients had truncus type II, and one patients had truncus type IIIc. Right ventricular pulmonary artery continuity was established with a porcine valved conduit in 6 patients, mechanical valved conduit in 1 patient, and bovine pericardial conduit in 3 patients. The postoperative right ventricular /left ventricular pressure ratio ranged from 0.4 to 0.71 [mean 0.51${\pm}$0.14]. The lung histology revealed grade II pulmonary obstructive disease even at 4 month of age. Five patients were dead in hospital [50%], and they were less than 2 year of age. One patient, who had severs congestive heart failure preoperatively, died of low output syndrome and the other died of low output syndrome with postoperative bleeding. There were three death, because of a pulmonary hypertensive crisis that might have been prevented. Two of the five survivors had conduit failure over a mean follow up of 42 months [range 1 to 78 months]. Obstructed conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and the patch of bovine pericardium and Dacron as patch the roof of the conduit. One patient died of acute cardiac failure during the operation. Although results in infants less than 2 years old have not been good, current improvement of intra-and postoperative care suggested that prompt repair is indicated for infants with truncus arteriosus.

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Stereotactic Sphenopalatine Ganglionotomy Using Radiofrequency Thermocoagulation -Case reports- (고주파열응고를 이용한 정위적 접형구개신경절절개술 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.227-230
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    • 1999
  • The sphenopalatine ganglion lies behind the middle nasal concha in the sphenopalatine foramen which connects the fossa to the nasal cavity. It has sympathetic and parasympathetic fibers as well as sensory fibers which innervate the nasal cavity, palate and nasopharynx. Current indications for blockade of the sphenopalatine ganglion include the management of migraine, cluster headache and a variety of facial neuralgias. Blockage of this ganglion can be attempted when more conservative treatments have failed. If the pain relief gained through the procedure is of short duration and the blockage needs to be repeated frequently, then radiofrequency thermocoagulation should be considered. Since the sphenopalatine ganglion lies close to the maxillary nerve, neurolytics can cause facial dysesthesia, radiofrequency thermocoagulation is the preferred method for ganglionotomy. Radiofrequency thermocoagulation of the sphenopalatine ganglion was done for 3 patients who suffered from postherpetic neuralgia, cluster headache, atypical facial pain respectively. Good results were obtained with the exception of the patient suffering from atypical facial pain. Although we were concerned about complications such as epistaxis, none were encountered. However it should be noted that caution must be exercised when repeatedly redirecting the cannula in the sphenopalatine fossa as serious bleeding and pronounced facial swelling may result.

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Traditional Korean Medical Treatment for Chemotherapy-induced Peripheral Neuropathy - a Case Report (항암제 투여 후 발생한 수족비증(手足痺症) 환자 치험례)

  • Yoo, Seung-Yeon;Jeong, Jong-Soo;Park, Jae-Woo;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.12 no.1
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    • pp.83-89
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    • 2007
  • Chemotherapy has many known side effects. Neuropathy is a common side effect when using cisplatin. The clinical course varies and depends on the agents used and their cumulative dose. Although symptoms can resolve completely, in most patients chemotherapy-induced peripheral neuropathy is either only partially reversible or completely irreversible. Current management for chemotherapy-induced peripheral neuropathy is symptomatic relief using membrane stabilizing medications and antidepressants. Dysaesthesia and pain involving the feet and hands are described in traditional korean medicine. In traditional korean medicine, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. We report a case of a 52 years old female patient treated with acupuncture and bleeding treatment for the goal of improving the symptoms of chemotherapy induced peripheral neuropathy. Further study and other medical method will be needed in order to improve the effect and determine the long-term effect of traditional korean medicine in treating Chemotherapy-induced Peripheral Neuropathy.

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Anticoagulant activities of piperlonguminine in vitro and in vivo

  • Lee, Wonhwa;Yoo, Hayoung;Ku, Sae-Kwang;Kim, Jeong Ah;Bae, Jong-Sup
    • BMB Reports
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    • v.46 no.10
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    • pp.484-489
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    • 2013
  • Piperlonguminine (PL), an important component of Piper longum fruits, is known to exhibit anti-hyperlipidemic, antiplatelet and anti-melanogenic activities. Here, the anticoagulant activities of PL were examined by monitoring activated-partial-thromboplastin-time (aPTT), prothrombin-time (PT), and the activities of thrombin and activated factor X (FXa). The effects of PL on the expressions of plasminogen activator inhibitor type 1 (PAI-1) and tissue-type plasminogen activator (t-PA) were also tested in tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) activated HUVECs. The results showed that PL prolonged aPTT and PT significantly and inhibited the activities of thrombin and FXa. PL inhibited the generation of thrombin and FXa in HUVECs. In accordance with these anticoagulant activities, PL prolonged in vivo bleeding time and inhibited TNF-${\alpha}$ induced PAI-1 production. Furthermore, PAI-1/t-PA ratio was significantly decreased by PL. Collectively, our results suggest that PL possesses antithrombotic activities and that the current study could provide bases for the development of new anticoagulant agents.

A Case of Ileoileocolic Type Intussusception Presented with Hematemesis Due to Meckel's Diverticulum (토혈이 동반된 멕켈 게실에 의한 회회맹장형 장중첩증 1례)

  • Bae, Soon Ho;Kwon, Young Dae;Kang, Ho Seok;Hwang, Su Kyung;Ko, Joon Tae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.56-59
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    • 2005
  • Intussusception is the most common cause of intestinal obstruction in early childhood and characterized by periodic colicky abdominal pain or irritability, vomiting, current jelly stool, and sausage-like abdominal mass. Meckel's diverticulum is common intestinal anomaly presenting with painless rectal bleeding during first 2 year of age. It is recognized as a common leading point of intussusception in childhood. Hematemesis is the rare clinical manifestation of both intussusception and Meckel's diverticulum. A 7-year-old girl presented with hematemesis was diagnosed as having intussusception by abdominal ultrasonography. Meckel's diverticulum was the leading point of intussusception in this case.

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