• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.341-344
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• 2008

The authors present a case of 68-year-old woman who underwent resection of a metastatic adenocarcinoma in the left parietooccipital area. The intraoperative course was uneventful; however, after closure of the scalp incision, increased bleeding from the suture line was noted. A computerized tomography scan that was performed immediately after operation revealed acute epidural hemorrhage with mass effect under the bone flap. The patient developed disseminated intravascular coagulation and immediate re-exploration was performed. This patient was successfully treated owing to early recognition of the condition and immediate treatment with transfusion. Neurosurgeons should be alert that hypercoagulabe state is common in cancer patients and consumptive coagulopathy can occur after resection of metastatic brain tumor.

• Neonatal Medicine
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• 제17권1호
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• pp.116-122
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• 2010

Kasabach-Merritt 증후군은 거대한 혈관종에 의해 혈소판이 소모되어 감소되는 드문 질환이다. 저자들은 재태주령 32주 미숙아에서 설명되지 않은 복수와 혈소판 감소증의 원인을 찾기 위해 시험적 개복술을 시행하여 장 혈관종을 발견하였으나 광범위하여 수술적 제거를 하지 못하고, SPECT로 확인 후 스테로이드 치료로 혈소판 감소증이 호전된 1례를 경험하였다. 따라서 다른 원인에 의해 설명되지 않는 혈소판 감소증과 파종성 혈관내 응고병증이 있으면 내부 장기의 혈관종을 의심해 볼 필요가 있다고 사료되었다.

• 한국임상수의학회지
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• 제39권6호
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• pp.373-377
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• 2022

Hypercoagulability is the most common coagulopathy seen in dogs with neoplasia, whereas a hypocoagulable state is relatively rare. A 16-year-old spayed female miniature Schnauzer presented with bilateral epistaxis, bilateral hindlimb swelling, and lameness. Previously, the dog was diagnosed with intermediate grade solid carcinoma after mastectomy, and then showed generalized ecchymoses on the abdomen and bilateral hindlimbs on presentation. Laboratory tests revealed a hypocoagulable state, including thrombocytopenia, hypofibrinogenemia, and delayed prothrombin and activated partial thromboplastin time. Thromboelastography demonstrated a prolonged K time with a decreased alpha angle and low maximal amplitude, reflecting a decrease in clot strength. The hypocoagulable state of disseminated intravascular coagulopathy was speculated based on the presence of an underlying tumor, clinical symptoms, and laboratory results of the hypocoagulable state. This case shows the incidence of hemostatic dysfunction as a paraneoplastic syndrome in a dog with mammary gland carcinoma.

• Clinical and Experimental Pediatrics
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• 제58권12호
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• pp.505-508
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• 2015

It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide, the patients' laboratory indications of DIC began to resolve. During this period, the patient received massive blood transfusion of a total of 311 units (26 units of red blood cells, 26 units of fresh frozen plasma, 74 units of platelet concentrates, 17 units of single donor platelets, and 168 units of cryoprecipitate), antithrombin-III and a synthetic protease inhibitor. Despite chemotherapy and radiation therapy, he died 1 year later because of disease progression. In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care is important to decrease malignancy-triggered procoagulant activities.

• Journal of Trauma and Injury
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• 제30권1호
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• pp.12-15
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• 2017

A 58-year-old male visited our emergency room for multiple traumas from explosion. On initial evaluation, hemopneumoperitoneum with liver laceration (grade 4) and colon perforation was identified. Hemopericardium with cardiac tamponade was also identified. Shrapnel was detected in the right ventricle. Damage control surgery was planned due to condition of hypotension. In operation room, control over bleeding was achieved after sternotomy, pericardiotomy, and laparotomy. Massive transfusion was done during operation. After gauze packing, operation was terminated with temporary closure (TC). Sanguineous fluid was drained profusely. Disseminated intravascular coagulopathy was confirmed through laboratory findings. No extravasation was discovered at hepatic angiogram. On re-operation, there was no active bleeding but oozing from sternotomy site was identified. Bone bleeding was impossible to control. Finally, reoperation was ended after gauze packing and TC all over again. The patient could survive for only a day after re-operation.

• 대한임상독성학회지
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• 제4권2호
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• pp.137-142
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• 2006

Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.375-382
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• 1986

We studied the effects of the acute intermittent peritoneal dialysis in severe acute renal failure of 1 newborn infant and 2 young infants during 18 months period from February 1985 to April 1986. The predisposing illnesses were severe acute gastroenteritis with dehydration. Reye's syndrome, and bilateral nephrolithiasis with hyperuricemia. The concomittent illnesses were severe hypernatremia, hyponatremia, hyperkalemia, hypocalcemia, hypoglycemia, DIC(disseminated intravascular coagulopathy), paralytic ileus, metabolic acidosis and gastrointestinal bleeding. As a dialvsate, Imperinol $solution^R$, 1.5% was used in all cases. The cycles of dialysis were 8, 16, and 41 times in each cases. Observed complications during dialysis were leakage, and abdominal wall and scrotol swelling in 2 cases, hyperglycemia in 1 case, and peritonitis in 1 case. Acinetobacter calcoaceticus was cultured in peritoneal fluid of peritonitis. These complications were treated by stopping dialysis in leakage and abdiminal wall swelling, insulin therapy in hyperglycemia, and intraperitoneal and systemic antibiotics therapy in peritonitis. We experienced improvements of severe acute renal failure with variable concomittant illnesses by acute intermittent peritoneal dialysis despite of the treatable complications of dialysis in all cases.

• Clinical and Experimental Pediatrics
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• 제46권11호
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• pp.1128-1130
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• 2003

신경모세포종 환아에서 레티노익산 치료 중 급성 췌장염이 합병되어 사망한 1례를 경험하여 보고하는 바이다. 레티노익산을 사용하는 환아에서 췌장염을 예방하기 위해서는 지속적인 혈중 지방 수치 추적이 필요할 것으로 생각되고 치료 중 호전을 보이더라도 지속적인 감시와 관찰이 필요할 것으로 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.124-129
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• 2017

Mycoplasma pneumoniae infections mainly involve respiratory tract; however, also can manifestate other symptoms by site involved. Extrapulmonary manifestations of M. pneumoniae infection are rarely known to occur without pneumonia. Herein we report a case of a 9-year-old boy who presented with acute cholestatic hepatitis in the absence of pneumonia. Rhabdomyolysis, skin rash, and initial laboratory results suspicious of disseminated intravascular coagulopathy were also observed in this patient. M. pneumoniae infection was identified by a 4-fold increase in immunoglobulin G antibodies to M. pneumoniae between acute and convalescent sera by enzyme-linked immunosorbent assay. This is the first pediatric case in Korea of M. pneumoniae infection presenting with acute cholestatic hepatitis in the absence of pneumonia.

• 한국동물위생학회지
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• 제44권1호
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• pp.35-43
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• 2021

Rabbit infectious hemorrhagic fever has been reported in rabbits worldwide. The disease is also frequently reported on Korean rabbit farms, and the pathological study of 9 rabbits on such disease-occurring farms was attempted to identify the pathogen. Clinical signs were torticollis and ear ulceration. Most rabbit died with bloody nasal discharges. At necropsy, multiple hemorrhages and inflammation were observed in heart, lung, liver and uterus. The main histopathologic features were hemorrhagic suppurative meningoencephalitis, fibrinous bronchointerstitial pneumonia, bacteremia, liver cell necrosis, multifocal hemorrhages in kidney and disseminated intravascular coagulopathy. The viral VP60 gene of RHDV was identified by Reverse Transcriptase PCR. Pasteurella multocida organisms were cultured, identified by biochemical test and serotyped as A by multiplex capsular typing PCR. In conclusion, the fatal hemorrhagic disease was due to combined infection with both RHDV and P. multocida in rabbits. To our knowledge, this is the first case report about co-infection with both RHDV and P. multocida in rabbits in Korea.