• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.620-626
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• 2017

Objective : Although venous thromboembolism (VTE) is frequently related to dehydration, the impact of dehydration on VTE in acute ischemic stroke (AIS) is not clear. This study investigated whether dehydration, as measured by blood urea nitrogen (BUN)/creatinine (Cr) ratio, influences the occurrence of VTE in patients with AIS. Methods : This is a retrospective study of patients with AIS between January 2012 and December 2013. Patients with newly diagnosed AIS who experienced prolonged hospitalization for at least 4 weeks were included in this study. Results : Of 182 patients included in this study, 17 (9.3%) suffered VTE during the follow-up period; in two cases, VTE was accompanied by deep vein thrombosis and pulmonary embolism. Patients with VTE were more frequently female and had higher National Institutes of Health Stroke Scale (NIHSS) score, more lower limb weakness, and elevated blood urea nitrogen BUN/Cr ratio on admission. In a multivariate analysis, BUN/Cr ratio >15 (odds ratio [OR] 8.75) and severe lower limb weakness (OR 4.38) were independent risk factors for VTE. Conclusion : Dehydration on admission in cases of AIS might be a significant independent risk factor for VTE.

• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.279-284
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• 2017

Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• Journal of Digestive Cancer Research
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• 제1권2호
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• pp.108-110
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• 2013

전체 정맥혈색전증 환자의 20% 이상이 암과 관련이 있고, 암 환자에 있어 혈색전증은 두 번째 사망 원인으로 작용하고 있어 이에 대한 효과적인 예방과 치료가 사망률을 감소시킬 수 있는 것으로 알려져 있다. 혈색전증 진단에 있어 혈액검사로 D-dimer 측정 및 영상검사로 도플러 초음파, 전산화단층혈관 촬영술을 사용한다. 치료 약제로 경구 비타민 K 길항제가 사용되었으나, 최근에는 정기적인 모니터링이 필요하지 않은 약제들이 새롭게 사용되고 있다. 저자들은 진행성 위암환자에서 발생한 하지 심부정맥 혈전증 및 폐동맥 혈색전증에 있어 저분자량 헤파린을 투여하며, 호전된 사례를 문헌고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9143-9146
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• 2014

Background: The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet volume (MPV), DVT and survival. Materials and Methods: Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study Results: The mean age was $59{\pm}20$. Forty-nine (63.6%) were men and 28 women (36.4%). Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients. Conclusions: Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.84-84
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• 2008

최근 견관절 질환의 상당수가 관절경 수술로 이루어지고 있다. 좌체위(beath chair position)를 이용한 관절경 수술은 시술 중 관헐적 방법으로의 전환이 용이하고 공간에 대한 orientation을 쉽게 잡을 수 있어 선호되고 있다. 또한 관절경 수술 시 시야 확보를 위해 epinephrine을 혼합한 세척액이 통상적으로 사용되고 있다. 관절경 수술 시 심부 정맥 혈전증(deep vein thrombosis), 가스 색전증, 세척액에 사용하는 epinephrine에 의한 심실성 빈맥 등과 같은 치명적인 부작용이 가끔 보고되어 있다. 관절경하 견관절 수술 도중 심실 빈맥의 발생은 매우 드문 경우이며 이에 대한 보고도 거의 없는 상태이다. 저자들은 2주의 기간 동안 좌체위로 관절경하 견관절 수술을 하는 도중 갑작스럽게 발생한 심실 빈맥 2예를 경험하였기에 원인 및 치료 과정을 보고하고자 한다. 좌체위로 인한 뇌혈류 저하, 가스 색전증 등의 증세는 없었다. 관절경술 도중 세척액에 투입된 소량의 epinephrine이 동시에 체내로 급속히 유입되어 심실 빈맥이 왔으리라 추정하고 있으며, 실험을 통해 이를 증명하고자 하였다.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.728-733
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• 2014

Background Periareolar Augmentation Mastopexy is one of the most challenging operations in plastic surgery. Problems with scar quality, areolar widening, and distortion are frequent problems that interfere with a predictable result. Methods A retrospective review was performed on fifty consecutive patients who underwent a periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30 had both preoperative and postoperative photographs and were the basis of the study. Results The age of the patients ranged from 19 to 56 years with the average age being 39 years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Four patients had complications following surgery for an overall complication rate of 13%. Two patients developed an infected Gore-Tex suture. Two of these complications were treated with revision surgery. Five patients required reoperation for an overall reoperative rate of 16% (one patient was converted to a full mastopexy). Conclusions As a result of this retrospective study, we have found the interlocking approach to periareolar augmentation/mastopexy to be a safe and reliable operation.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.164-167
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• 2011

Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.654-660
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• 1998

Pulmonary embolism is one of the moot common acute pulmonary disease in the adult general hospital population However, the disease is still frequently unsuspected and underdiagnosed due to the nonspecificity of both clinical findings and laboratory tests. The chest radiography in a patient suspected acute pulmonary embolism do not provide adequate information to establish or exclude the diagnosis of pulmonary embolism. Even in the case of infarction, there is no pathognomonic clues on the chest film. Rarely infarction presents unusual roentgenologic manifestation such as lobar consolidation, coin lesion, multinodular opacity, or massive pleural effusion Especially, lobar consolidation in pulmonary embolism might mislead into the diagnosis of pneumonia. We experienced a case of pulmonary embolism presenting lobar consolidation in a 62 years old woman, originated from deep vein thrombosis. She took a compression stocking and underwent anticoagulant therapy with excellent outcome.

• Journal of Chest Surgery
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• 제50권3호
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• pp.224-227
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• 2017

A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.