• 제목/요약/키워드: Haemorrhage

검색결과 22건 처리시간 0.029초

Diagnosis and Management of Post-Partum Hemorrhage Caused by Acquired Hemophilia A: A Case Report

  • Rashid, Nawshirwan G.;Amin, Shaema Salih;Abdulqader, Aveen M. Raouf
    • 대한임상검사과학회지
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    • 제54권2호
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    • pp.163-166
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    • 2022
  • Acquired hemophilia A (AHA) is an uncommon autoimmune bleeding disorder in which autoantibodies that affect the functions of factor VIII (FVIII) are present in the blood. The initial diagnosis of AHA is difficult as the presentations of AHA differ from those of congenital hemophilia A. Moreover, the treatment of AHA is more complex due to the presence of autoantibodies against FVIII. Here, we present a case report of postpartum AHA, to increase the perception and knowledge regarding the recognition and management of such cases. We present a young female with the chief complaint of vaginal bleeding and upper arm ecchymosis. Laboratory results exhibited isolated prolonged activated partial thromboplastin time (APTT) and FVIII inhibitors. The patient was treated with corticosteroids, FVIII concentrates, and a bypassing agent. In conclusion, unexplained postpartum bleeding, unmanageable with basic hemostatic measures, should lead to clinical suspicion of an acquired bleeding disease.

푸사리움속 곰팡이에 오염된 보리와 보리겨의 급여가 비육돈 및 육성빈돈의 생산성 및 사료이용효율에 미치는 영향 (Effects of barley and barley bran contaminated with Fusarium spp. on the growth and feed efficiency of fattening and growing pigs)

  • 이왕식;이현준;기광석;노환국;강석진;정영훈;백광수;허태영
    • 대한수의학회지
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    • 제52권1호
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    • pp.45-52
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    • 2012
  • The present study was carried out to investigate the effect of barley and barley bran contaminated with Fusarium spp on growth performance and feed efficiency of fattening and growing pigs. In experiment 1, total 48 fattening Landrace pigs were used in a fattening trial for 71 days. Pigs weighing around 75 kg were allocated into different substitution groups containing 0, 10, 20 and 30% of barley contaminated Fusarium spp. In experiment 2, total 16 growing Landrace pigs were used in a growing trial for 45 days. Pigs weighing around 29.4 kg were allocated into different substitution groups containing 0, 5, 10 and 20% of barley bran contaminated Fusarium spp. Mycotoxin concentrations of barley and barley bran contaminated with 30% Fusarium spp were 0.452 and 1.049 ppm for deoxynivalenol, 8.125 and 17.646 ppm for nivalenol and 0.023 and 0.029 ppm for zearalenone, respectively. In experiment 1, no differences were found in weight gain and feed intake between control group (0%) and 10 or 20% substitution groups, but in 30% substitution group, weight gain and feed intake were significantly lower (p < 0.05) than those in control group. After slaughtering, the extended haemorrhage of the fundus region in stomach was observed in 20 or 30% substitution groups. In experiment 2, weight gain and feed intake were not significantly different among treatment groups. After slaughtering of experimental pigs, the extended haemorrhage of the fundus region in stomach was observed in pigs fed diet with 20% substitution group. These results suggest that the feeding of diet with contaminated highly levels of Fusarium spp was negative effect on growth and feed efficiency in growing and fattening pig.

Outcome of Pars Plana Retinopexy with Perfluoro-n-octane-Silicone Oil Exchange for Rhegmatogenous Retinal Detachment in Dogs: 9 Eyes

  • Susanti, Lina;Kang, Seonmi;Park, Sangwan;Park, Eunjin;Park, Yoonji;Kim, Boyun;Jeong, Manbok;Seo, Kangmoon
    • 한국임상수의학회지
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    • 제35권4호
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    • pp.126-129
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    • 2018
  • This study was performed to describe the outcome of pars plana retinopexy with perfluoro-n-octane (PFO)-silicone oil (SiO) exchange in dogs with rhegmatogenous retinal detachment in Seoul National University Veterinary Medical Teaching Hospital (SNU VMTH) from 2014 to 2017. Nine eyes of 8 dogs were included in this study. Medical records including signalment, history, duration from onset of blindness to surgical intervention, pre-operative findings, duration from surgery to regaining vision, and post-operative complications were evaluated. No eyes were visual before surgery. Duration from onset of blindness to surgical intervention was 2-30 days (median 8 days); duration from surgery to regain vision was 1-14 days (median 6 days); follow-up time was 15-1088 days (median 69 days). Post-operative complications were divided as temporary vs permanent conditions. Temporary complications were corneal ulcer, uveitis, retinal haemorrhage, glaucoma, subconjunctival leakage of SiO, and vitreal haemorrhage. Permanent complications were anterior chamber migration of SiO, retinal degeneration, corneal degeneration, re-detachment, and cataract. Six of 9 eyes regained functional vision, five of which remained visual throughout the follow-up time while the other one lost vision after 3 months because of uveitic glaucoma. In conclusion, pars plana retinopexy with PFO-SiO exchange provided fair outcome in 66.7% cases described in this study.

악교정 수술후 발생한 감염 4증례 (POST-OPERATIVE INFECTIONS FOLLOWING THE ORTHOGNATHIC SURGERY : CASE REPORTS)

  • 김종섭;박진호;박희대;이창곤;이희경;진병로
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권1호
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    • pp.46-54
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    • 1995
  • Postoperative infection following orthognatic surgery is rare. When postoperative infections occur, the initial treatment consists of incision and drainage of the affected area, culturing to identify bacterial stains and verify antibiotic sensitivity, and the institution of the appropriate antibiotic regimen. Some plates and screws may eventually require removal, the initial therapy should be attempted to retain the plates and screws until adequete healing has taken place. In orthoganthic surgery, intra-operative complications as a lesion of inferior alveolar nerve, fracture of osteomised segments, incomplete sectioning, malposition of segments, haemorrhage may occur. The surgeon should be familiar with possible complications to be caused and how to manage them. Prevention of postoperative infection following the orthognathic surgery consists of minimal periosteal reflection, aseptic management of operation field, proper surgical technique, rigid fixation, prophylactic antibiotics.

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Clostridium perfringens A형균 감염증에 의한 비육우의 임상 및 병리학적 연구 (Clinical and pathological studies on the feedlot cattle caused by Clostridium perfringens type A infection)

  • 이차수;지영흔
    • 한국수의병리학회지
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    • 제1권1호
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    • pp.53-60
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    • 1997
  • Enterotoxemia caused by Clostridium perfringens(Cl. perfringens)has occurred sporadically with devastating effect in Korean cattle. The disease is confirmed by detecting bacterial toxin the interstinal contents. however diagnosis has been challenging since the toxin is short lived and it must be demonstrated within one hour following death. The purpose of this paper is to provide additional clinicall and pathological information derived from observation of cattle administered with Cl. perfringens type A and/or its toxins isolated from natural case. Clinically cattle died suddenly in lateral recumbency with dyspnea tachycardia and muscle tremor without increased rectal temperature. hematology showed leukopenia with absolute decrease of all leukocytes. Blood glucose AST and ALT were increased. Grossly lungs were hyperemic haemorrhagic and edematous. Small intestine especially ileum was hyperemic and hemorrhagic with diffuse areas of necrosis. This study demonstrated that death without increased rectal temperature combined with leukopenia increased serum glucose pulmonary haemorrhage and edema plus necrotizing ileitis are important features associated with enterotoxemia due to Cl. perfringens type. A.

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백서에서 유발된 염증에 대한 Triamcinolone Acetonide 이온도입 경피투과 효과 (The Effects of Triamcinolone Acetonide by Iontiophoretic Transdermal Delivery on Inflammation Induced Rat)

  • 정대인;김태열;김계엽;김명훈
    • The Journal of Korean Physical Therapy
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    • 제15권2호
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    • pp.182-195
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    • 2003
  • This study investigated the effects of triamcinolone acetonide by iontophoretic transdermal drug delivery on anti-inflammatory action into the rats and which had carrageenan-induced hyperalgesia and edema in the feet, trauma-induced tissue damage in the thigh. Each group was treated under the fellowing conditions. 1. Group I : Control group 2. Group II : Application of direct current 3. Group III : Application of 0.1$\%$ triamcinolone acetonide solution 4. Group IV : Iontophoresis of 0.1$\%$ triamcinolone acetonide solution The degree of anti-inflammation was evaluated by the paw withdrawal latency, the change in volume of foot the change of paw edema, histological change in rats. 1. In paw withdrawal latency, group IV showed the most significant therapeutic effect than the other groups at 0, 3, 6 and 9 hours(p < 0.001). 2. In paw edema experiment in the foot, group IV showed the most significant effect than group I at 0, 3, 6 and 9 hours. It meant that there was effective anti-inflammatory reaction in group I (p < 0.001). 3. In the light microscopic observation, group IV showed the most significant reduction of haemorrhage, hyperemia and infiltrative inflammation. From the results, the iontophoresis with triamcinolone acetonide is more effective than using each groups. It is one of the effective physical agent which delivered large molecular weight drug into the body. The continuous study is needed for many interesting issues of iontophoretic transdermal drug delivery in new future.

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The impact of a quality improvement effort in reducing admission hypothermia in preterm infants following delivery

  • Choi, Han Saem;Lee, Soon Min;Eun, Hoseon;Park, Minsoo;Park, Kook-In;Namgung, Ran
    • Clinical and Experimental Pediatrics
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    • 제61권8호
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    • pp.239-244
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    • 2018
  • Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.

Salvage Transoral Robotic Surgery for Recurrent or Residual Head and Neck Squamous Cell Carcinoma: A Single Institution Experience

  • Dabas, Surender;Dewan, Abhinav;Ranjan, Reetesh;Dewan, Ajay Kumar;Shukla, Himanshu;Sinha, Rupal
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7627-7632
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    • 2015
  • Background: The present study was conducted to evaluate the technical feasibility, safety and adequacy of surgical margins with salvage transoral robotic surgery (TORS) for recurrent or residual head and neck squamous cell carcinoma patients. Materials and Methods: Thirty patients who underwent salvage TORS using the 'DaVinci' robot were enrolled in the study and data related to their surgical time, complications and functional outcome were recorded. Results: The feasibility of salvage TORS in our study was observed to be 100%. Positive margins were encountered in only 6.7% of patients. Mean blood loss was 23.3 ml with no patient requiring blood transfusion. Postoperative complications in the form of primary haemorrhage requiring active surgical intervention occurred in 13.3%. Oral feeding could be started as early as the 3rd postoperative day in a few patients, with nasogastric tubes being removed on the 12th postoperative day. Long term gastrostomy tube dependency was seen in 10% cases. Median survival of patients was 19 months. Conclusions: Salvage TORS is a safe, effective and feasible option in the management of treatment failure cases. It offers an alternative surgical approach with unexpected benefits in terms of tracheostomy tube use, Ryle's tube and gastrostomy dependence.

고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB (Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study)

  • 조현주;정혜진;임사비나
    • 대한한의학회지
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    • 제40권3호
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

Pantotheic acid 결핍에 의한 동자개(Pseudobagrus fulvidraco)치어의 사료성 아기미병 (Gill Disease of Pseudobagrus fulvidraco Fingerlings by Deficiency of Pantothenic acid)

  • 이경희;박성우;김영길
    • 한국어병학회지
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    • 제13권1호
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    • pp.21-29
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    • 2000
  • 1997년 9월 전북 부안군 소재의 동자개(Pseudobagrus fulvidraco) 양어장에서 작은 소리에도 과도하게 놀라고, 새변의 유착과 곤봉화를 특징으로 하는 질병이 발생하여 대량폐사를 초래한 pantothenic acid 결핍에 의한 사료성 아가미병의 병리상과 사망률을 줄이기 위한 방책을 수립하였다. 질병이 발생한 양어장의 수질은 다른 양어장의 수치와 비슷하였고, 병어에서 세균이 분리되지 않았다. 병어는 적혈구 수, Hb, Ht 및 간중량지수의 감소, 적혈구의 소형화와 간의 위축을 나타내는 전형적인 pantothenic acid 결핍에 의한 사료성 아가미병으로 판명되었다. 새변의 상피세포의 증생과 유착을 완화시키기 위해 0.5%와 0.6% 식염을 첨가하여 10일간 사육한 결과 0.5%와 대조구(식염 무첨가구)는 100% 사망하였으나, 0.6% 식염 첨구가구는 75%의 생존율을 나타냄과 동시에 새변 상피세포의 증생과 유착이 감소하였다. Pantothenic acid 10 mg/kg 사료를 25일간 급이하며 5, 10, 15, 25일 간격으로 채취하여 질병의 호전상태를 혈액학적, 병리조직학적으로 검사한 결과 pantothenic acid 첨가사료 급이 25일 후 적혈구 수, Hb, Ht, 간중량지수와 아가미 조직도 정상의 상태로 회복되었다. 병리조직학적 검사에서는 15일부터 상피세포의 증생이 줄어들어 호흡면적이 현저하게 증가하였고 급이 25일 후에는 거의 정상상태로 회복되었다. 본 연구의 결과 동자개의 pantothenic acid 결핍에 의한 사료성 아가미병의 경우 식염 0.6%에서 사육하는것과 pantothenic acid 10 mg/kg 사료 첨가하여 최소한 25일간 사육하는 것이 효과적인 것으로 나타났다.

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