• Title/Summary/Keyword: Risk of bleeding

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Association between Oral Health Behavior and Oral Health Status in Adolescent (청소년의 구강건강행태와 구강보건상태와의 관련요인)

  • Oh, Jungsuk
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.4
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    • pp.103-112
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    • 2017
  • Purpose : This study was conducted to improve cognitive oral healthcare care by analyzing the correlation between oral health behavior and oral health status Korean adolescents. The subjects were 65,528 youths in 798 schools monitored in the Twelfth Korea Youth Risk Behavior Web-based Survey in 2016. Methods : The general characteristics consisted of 9 items including sex, grade, and academic performance. The academic performance and economic status were restructured into "upper, middle, lower". Subjective health perception and subjective oral health perception were reorganized as "health", "normal", "no health". The sub-areas of oral health behavior include five times of daily brushing during the day yesterday. The number of brushing times was "0", "1-2", "3", "more than 4" After lunch at school, brushing was restructured as "always," "sometimes," "not." The oral health status subscale consisted of 6 items including tooth breakage and toothache at the time of eating. Result : Tooth fracture(43.7 %), pain in mastication(43.7 %), tooth tingling(47.4 %), gum pain and bleeding(45 %), pain in buccal mucosa(43.8 %) and halitosis(46.6 %) were rare in adolescent having healthy oral health status cognitively(P<.001). Nosymptom adolescents without dental sealant showed low tooth fracture(0.64 times), pain in mastication(0.67 times), tooth tingling(0.59 times), gum pain and bleeding(0.84 times), pain in buccal mucosa(0.76 times), and halitosis(0.90 times). Nosymptom adolescents without scaling showed low tooth fracture(0.88 times), pain in mastication(1.03 times), tooth tingling(0.82 times), gum pain and bleeding(0.64 times), pain in buccal mucosa(0.70 times) and halitosis(0.82 times). Conclusion : This study revealed that oral health status is correlated with oral health behavior. Development of educational media and program, and aggressive promotion required to establish oral health Korean adolescent.

Life-Threatening Lower Gastrointestinal Hemorrhage in Pediatric Crohn's Disease

  • Kim, Earl;Kang, Yunkoo;Lee, Mi Jung;Park, Young Nyun;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.1
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    • pp.53-60
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    • 2013
  • In Crohn's disease, mild gastrointestinal bleeding often occurs; however massive gastrointestinal hemorrhage, which can have a dramatic effect on a patient's vital sign, is rare. This could result in potentially life-threatening complications, which can lead to death. Massive hemorrhagic Crohn's disease is not well known and for this reason, they are a diagnostic and therapeutic challenge. Various diagnostic and therapeutic methods are currently being developed and used. The surgical method is often used only as a last measure since this approach has the risk of serious complications that may endanger patients. However, if massive bleeding continues even after all therapeutic methods are used, the surgical method must be implemented. In this case, all therapeutic methods were found to be ineffective; therefore, surgery was used as a last option. Ultimately, the surgical method was found to be successfully used to treat life-threatening hemorrhagic Crohn's disease.

A Case Report of Prolonged Hemorrhage Following Traditional Phlebotomy (Fasd)

  • Sajjad Sadeghi
    • Journal of Pharmacopuncture
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    • v.27 no.1
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    • pp.47-52
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    • 2024
  • Phlebotomy, a therapeutic method of bloodletting typically performed using a needle, has a traditional technique known as "Fasd." In this method, blood is extracted by creating a longitudinal incision on a vein (3-5 mm) with a surgical scalpel blade, usually blade No. 11. Due to the incision in the vessel wall, establishing hemostasis is more challenging compared to conventional methods. Hemostasis is usually achieved within minutes after Fasd. We present a case highlighting an uncommon yet significant complication of traditional phlebotomy. A 55-year-old man with no prior medical conditions underwent traditional phlebotomy at an academic traditional medicine clinic. Senior MD-PhD students in Iranian Traditional Medicine, under professor supervision, performed Fasd. A sterile scalpel blade No. 11 was used to create a longitudinal incision of approximately 4 mm on the patient's median basilic vein in the right hand. After removing 400 cc of blood, a pressure dressing was applied to the incision site. Despite attempts such as hand elevation, ice pack application, prolonged direct pressure, and tight elastic bandaging, bleeding from the incision persisted. After an hour of supportive therapy, hemostasis was eventually achieved within a few minutes using burnt cotton dressing (a traditional method for blood hemostasis). Following intravenous hydration, the patient was discharged in stable condition and reported no issues during the one-month follow-up. The traditional phlebotomy (Fasd) carries the risk of serious complications, including uncontrolled and prolonged bleeding. Further research on the efficacy and safety of burnt cotton dressing for controlling hemostasis is recommended.

Early and Late Results after Mitral Valve Replacement (승모판막 치환후 조기및 장기추적결과)

  • 김명인
    • Journal of Chest Surgery
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    • v.25 no.2
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    • pp.149-157
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    • 1992
  • Total 145 cases mitral vlave replacement were performed in Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from May 1983 to July 1991. Sixty-one patients were male and 84 patients were female and the range of age was from 12 to 66 years old with the mean of 37.9[$\pm$11.6] years. Valvular lesions were 49 cases of mitral stenosis, 18 cases of regurgitation and 78 cases of combined lesion. Used valve were Ionescu-Shiley[42 cases], Bjork-Shiley[49 cases], Inact[6 cases], St. Jude Medical[11 cases] and CarboMedics[37 cases]. Mean size of valve was 29.8$\pm$1.68mm. Early morality was 13.8%[20 cases] and low output syndrome was most common cause[9 cases]. Age, functional classification and biventricular hypertrophy were risk factors. All survived cases were followed up without missing. Mean follow up period were 3 years and 3 months. Total 14 cases of death[9.7%] were observed and heart failure, unexplained sudden death and bleeding were the causes in that order. Common late complications were heart failure and bleeding related with anticoagulation. Actuarial survival rate at 5 years was 83$\pm$5.4% in overall, 78$\pm$7.2% in tissue valve group, 87$\pm$6.8% in mechanical valve group. The actuarial freedom rate from thromboembolism at 7 years was 89$\pm$8.3% in overall, 86$\pm$9.9% in tissue valve group and 97$\pm$1.9% in mechanical valve group. Actuarial freedom rate from bleeding at 5 years with anticoagulation was 88.9$\pm$4.2% in overall, 96$\pm$3.9% in tissue valve group, 86$\pm$4.6% in mechanical valve group. Reoperation was done in 3 cases with heart failure with tricuspid regurgitation and thromboembolism in 2 cases. The functional status of survived cases was I or II.

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Clinical Experience of Multiple Valve Replacement (다중판막치환술에 대한 임상적 연구)

  • 조창훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1346-1353
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    • 1992
  • From Febrary 1984 to July 1992, 138 cases of multiple valve replacements were performed at the Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University. There were 81 females and 57 males, and their ages ranged from 19 to 60 years [mean age, 40.1$\pm$10.9 years]. Thirteen of these patients had undergone previous cardiovascular procedures, with an average of 76.3 months between procedures[range, 3 to 180 months]. Mitral and aortic valve replacement were done in 135 patients, 2 underwent triple valve replacement and 1 underwent mitral and tricuspid valve replacement. Associated procedures were necessary in 20 patients[14.5%]. The operative mortality was 5.8% and the most common cause was low cardiac output. Late follow-up of 83% has been accomplished in 130 early survivors, with a late mortality of 5.9%. The late mortality was due to valve thrombosis in 2 patients, cerebral infarction in 1, heart failure in 1, arrhythmia in 1, and bleeding in l. Of those patients who survived, New York Heart Association functional class improved significantly[from 70% class III and IV before to 88% class I and II after]. Actuarial survival rate including all deaths was 88.8% at 8 years. The follow-up studies revealed that thromboembolism, reoperation and bleeding rate were 1.2%/patient-year, 0.85% /patient-year and 0.57%/patient-year at 8 years postoperatively. We concluded that valve thrombosis, embolism, and anticoagulant-related hemorrhage were the main risk factors of longterm survival of patients.

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Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group?

  • Acmaz, Gokhan;Aksoy, Huseyin;Albayrak, Evrim;Baser, Muruvet;Ozyurt, Sezin;Aksoy, Ulku;Unal, Dilek
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.195-198
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    • 2014
  • Aim: To evaluate precancerous lesions such as hyperplasia and endometrial polyps in obese postmenopausal women. Materials and Methods: Women who were referred with abnormal uterine bleeding in postmenopausal period or the presence of endometrial cells on cervical cytology in our department were investigated. Anthropometric measurements such as height, weight, body mass index, waist/hip ratio and endometrial thickness were compared between a precancerous lesion (hyperplasia and endometrial polyp) group and a pathologically normal group. Results: We detected statistically significant thickening of endometrium in patients with precancerous lesions. Moreover patients with precancerous lesions had higher body mass index than the pathologically normal group. Conclusions: We found elevated precancerous lesion rates in overweight and obese women in the postmenopausal period, of interest given that the prevalence of obesity is increasing in most parts of the world. Although screening for endometrial cancer is not recommended for the general population, in high-risk populations like obese postmenopausal women, it may be very important.

The Problem of Leech Application in Digital Replantation (수지첨부 재건 후 거머리 사용시 발생하는 문제점에 대한 고찰)

  • Lee, Nae Ho;Yang, Kyoung Moo
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.158-163
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    • 2000
  • Over the past several years, countless patients have benefitted from the use of leeches in microsurgery. As we know, leeches are used to overcome the problem of venous congestion by creating prolonged localized bleeding uniquely characteristics of leech bite. Venous congestion, a common complication of digital replantation, often has been treated through surgical repair like arteriovenous anastomosis. The leech produces a number of important substances which contribute to the special property of the bite, including an anticoagulant, a local vasodilator and local anesthetics. The bite usually bleeds for 1 to 2 hours and under special circumstances may bleed for up to 24 hours. So venous congestion is relieved. However, leeches increase the possibility of infection through their gut content. Infection associated medical leech application is significant risk. Other risk include allergic reaction, adverse psychologic reaction and blood loss requiring transfusion. The 65 cases of medical leech application were performed between August, 1997 and May, 2000 according to an established protocol. The complication were 18 cases ; infection (13 cases), hemorrhage (2 cases), allergic reaction (1 case), psychologic problem (1 case) and hypochromic anemia (1 case). Then our study was performed on the base of indication. As a result, Aeromonas hydrophilia was cultured from gut of medical leech and Klebsiella, Staphylococcus and Pseudomonas were cultured from media. We present the clinical risk-benefit of the medical leech therapy through several cases following digital replantation.

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Long lasting mesalazine-induced pancytopenia in a patient with ulcerative colitis

  • Ko, Juyeon;Song, Hyun Joo;Han, Sanghoon;Moon, Chiyoon
    • Journal of Medicine and Life Science
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    • v.16 no.2
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    • pp.46-51
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    • 2019
  • Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

Deep Vein Thrombosis Prophylaxis after Total Hip Arthroplasty in Asian Patients

  • Kim, Jun-Shik
    • Hip & pelvis
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    • v.30 no.4
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    • pp.197-201
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    • 2018
  • In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors. However, Asian patients who have undergone THA have a strikingly low prevalence of DVT and virtually no postoperative PE. Some authors suggest low clinical prothrombotic risk factors and the absence of some DVT-related genetic factors in Asian patient populations decrease the risk of DVT, PE or both. In Korea, the prevalence of DVT after THA without thromboprophylaxis have ranges from 6.8% to 43.8%, and asymptomatic PE have ranges from 0% to 12.9%; there have been only two reported cases of fatal PE. Deep-wound infections resulting from postoperative hematomas or prolonged wound drainage have been reported with routine thromboprophylaxis. The prevalence of DVT differs varies based on patient ethnicity. Guidelines for the use of thromboprophylaxis were altered and focus on the potential value of outcomes compared with possible complications (e.g., bleeding).

Posttransplant Lymphoproliferative Disorder in Pediatric Liver Transplantation: Samsung Medical Center Experience (소아 간이식에서 Posttansplant Lymphoproliferative Disorder (PTLD): 삼성서울병원의 경험)

  • Choe, Yon-Ho;Lee, Suk-Koo;Seo, Jeong-Meen;Joh, Jae-Won;Kim, Sung-Joo;Lee, Kwang-Woong;Park, Je-Hoon;Ko, Young-Hye;Kwon, Ki-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.1
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    • pp.39-46
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    • 2003
  • Purpose: In a retrospective study for the pediatric patients who underwent liver transplantation in the past 6 years at Samsung Medical Center, the clinical features of 5 patients with posttransplant lymphoproliferative disorder (PTLD) were analyzed. Methods: Between June 1996 and June 2002, 41 pediatric patients underwent liver transplantation. Seven of them died in the postoperative period. Thirty-five including one patient who died of PTLD were finally reviewed. Patients were divided into two groups: high risk group, EBV naive recipients of EBV-positive grafts; low risk group, the patients other than those in high risk group. The authors reviewed age at operation, immunosuppressive agent, postoperative duration until diagnosis, postoperative duration until EBV seroconversion, presence of treatment against rejection, and presenting symptoms of PTLD. Results: Five of 41 patients (12.2%) developed PTLD. All of them belonged to high risk group, and the incidence of PTLD in high risk group was 31.3% (5/16). The mean age at operation was 10.8 months old and the mean duration between operation and diagnosis for PTLD was 9.8 months. Primary EBV infection developed after a median of 6 months after transplantation. One patient was diagnosed as laryngeal and gastrointestinal PTLD and the other four, gastrointestinal PTLD. The following symptoms and signs were seen in the patients: anemia (100%), hypoalbuminemia (100%), fever (80%), diarrhea (80%), gastrointestinal bleeding (80%), and anorexia (60%). Conclusion: PTLD is one of the major complications after pediatric liver transplantation, especially in the group of high-risk recipients. Anemia, hypoalbuminemia, fever, diarrhea and gastrointestinal bleeding were features that are characteristic of PTLD. The common features of PTLD development were: (i) EBV-positive donors placed into EBV naive recipients, (ii) primary EBV infection about 6 months after transplantation, (iii) young age, about 1 year old at operation, and (iv) the requirement for intensive posttransplant immunosuppression.

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