• Title/Summary/Keyword: Risk of bleeding

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Early Results of Mitral Valve Reconstruction in Mitral Regurgitation (승모판막 폐쇄부전에 있어 승모판막 성형술의 단기성적)

  • Kim, Kyung-Hwan;Won, Tae-hee;Kim, Ki-Bong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.32-37
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    • 2000
  • Background: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. Material and Method: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9$\pm$14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. Result: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. Conclusion: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.

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Analysis of the Prognostic Factors for Abdominal Trauma (복부외상환자의 예후에 영향을 미치는 인자들에 대한 분석)

  • Kim, Hee Joon;Kim, Hyung Soo;Seo, Kyung Won;Ju, Jae Kyun;Ryu, Seong Yeop;Kim, Jeong Cheol;Kim, Hyung Rok;Park, Young Kyu;Kim, Dong Yi;Kim, Young Jin;Kim, Shin Kon
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.12-18
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    • 2007
  • Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality. Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test. Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<$50,000/mm^3$), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ. Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.

Effects of Kamut Wheat Enzyme Diet on Dextran Sulfate Sodium-induced Colitis Mice (카무트밀 효소 식이가 Dextran Sulfate Sodium으로 유발한 대장염 마우스에 미치는 효과)

  • Bum Ju Kil;Chae Yun Baek;Juni Lee;Ye Seul Hwang;Yeojin Choi;Joo Hee Son;Miae Yoo;Dong Hoon Lee;Donghun Lee
    • The Korea Journal of Herbology
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    • v.39 no.1
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    • pp.31-38
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    • 2024
  • Objectives : Ulcerative colitis is a chronic recurrent inflammatory disease of the gastrointestinal tract. However, there are some drawbacks to long-term drug therapy such as the risk of opportunistic infections. Recently, there was an increasing interest on the use of khorasan Kamut wheat because of their higher value of selenium and fiber than modern wheat. The present study was aimed to investigate the effect of Kamut brand wheat enzyme (Kamut WE) diet on colon health in dextran sulfate sodium (DSS)-induced colitis mice. Methods : Female C57BL/6J mice were divided into 6 groups. (1) normal (Water and AIN-93G diet), (2) control (1.25% DSS and AIN-93G diet), (3) Kamut WE (1.25% DSS and Kamut WE diet), (4) normal (Water and AIN-93G diet), (5) control (2.50% DSS and AIN-93G diet), (6) Kamut WE (2.50% DSS and Kamut WE diet). Dietary intake, body weight change, disease activity index (DAI), colon length and spleen weight were monitored. Results : Kamut WE group alleviated colitis symptom, including dietary intake loss, DAI (weight loss, loose stools, bleeding), colon length shortening and spleen swelling. Further, Kamut WE diets showed a significant effect against pathological damage by the increased colon length, decreased DAI and spleen weight in DSS 1.25% as well as DSS 2.50%. Conclusions : Our study provides evidence that Kamut WE diet increased colon length, decreased DAI and spleen weight in intestinal inflammation.

Surgical Experience of Ascending Aorta and Aortic Valve Replacement in Patient with Calcified Aorta

  • Chung, Sur-Yeun;Park, Pyo-Won;Choi, Min-Suk;Cho, Seong-Ho;Sung, Ki-Ick;Lee, Young-Tak;Jeong, Jae-Han
    • Journal of Chest Surgery
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    • v.45 no.1
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    • pp.24-29
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    • 2012
  • Background: The conventional method of aortic cross-clamping is very difficult and increases the risk of cerebral infarct due to embolism of the calcified aorta in these patients. Accordingly, we analyzed our experience with 11 cases of ascending aorta and aortic valve replacement with hypothermic circulatory arrest. Materials and Methods: From January 2002 to December 2009, 11 patients had ascending aorta and aortic valve replacement with hypothermic arrest at our hospital. We performed a retrospective study. Results: There were 5 males and 6 females, with a mean age of 68 years (range, 44 to 82 years). Eight patients had aortic stenosis, and 3 patients had aortic regurgitation. An aortic cannula was inserted into the right axillary artery in 3 patients and ascending aorta in 6 patients. Two patients with aortic regurgitation had a remote access perfusion catheter inserted though the right femoral artery. The mean cardiopulmonary bypass time was 180 minutes (range, 110 to 306 minutes) and mean hypothermic circulatory arrest time was 30 minutes (range, 20 to 48 minutes). The mean rectal temperature during hypothermic circulatory arrest was $21^{\circ}C$ (range, $19^{\circ}C$ to $23^{\circ}C$). No patient had any new onset of cerebral infarct or cardiovascular accident after surgery. There was no hospital mortality. Early complications occurred in 1 patient who needed reoperation due to postoperative bleeding. Late complications occurred in 1 patient who underwent a Bentall operation due to prosthetic valve endocarditis. The mean follow-up duration was 32 months (range, 1 month to 8 years) and 1 patient died suddenly due to unknown causes after 5 years. Conclusion: Patients with a calcified aorta can be safely treated with a technique based on aorta and aortic valve replacement under hypothermic circulatory arrest.

TREATMENT OF CAPILLARY HEMANGIOMA ON MAXILLARY BUCCAL MUCOSA : A CASE REPORT (상악 협측 치은에 발생한 모세혈관종 치험례)

  • Kang, Keun-Young;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.680-684
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    • 2004
  • The hemangioma, a benign proliferation of blood vessel, is the most common tumor of infancy and childhood. In many instances, the lesion probably represents a hamartoma or malformation rather than a true neoplasm. In the oral cavity, common sites are lips, followed by tongue, buccal mucosa and palate. Clinical characteristics appear as a flat or raised reddish-blue lesion and are generally solitary. They are classified on the basis of their histological appearance into capillary, mixed, cavernous or a sclerosing variety. A 6-year-old male of this case was referred to the Department of Pediatric Dentistry, Chonnam National University with a chief complaint of swelling lesion on gingiva. The strawberry appearance mass was detected by clinical examination on attached gingiva at the upper left primary lateral incisor and canine. Surgical excision and biopsy were carried out for histological examination and the lesion was diagnosed with a capillary hemangioma. The risk of recurrence after this therapy is rare, and there is no malignant transformation. Despite their benign origins and behaviour, hemangiomas in the region of oral cavity are always clinically important to the dental profession because of bleeding tendency.

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DENTAL TREATMENT OF A PEDIATRIC PATIENT WITH HOMOZYGOUS PROTEIN C DEFICIENCY: A CASE REPORT (동형접합성 단백 C 결핍 환아의 치과적 치험례)

  • Yoon, Mi;Kim, Seung-Oh;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.207-212
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    • 2010
  • Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.

The relationship between of snack habits, oral health behavior and oral health status in middle and high school students (중고생들의 식습관 및 구강보건행태와 구강건강 상태의 관련성 연구)

  • Hyun-Kyung Yun;Jong-Hwa Lee;Da-Hye Hwang
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.1-12
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    • 2023
  • Objectives: This study attempted to identify the eating habits and oral health behaviors of Korean teenagers, studying their relationship with oral health status. The findings serve as fundamental data to enhance proper eating habits and oral health-related projects, ultimately improving teenagers' oral health. Methods: It was analyzed through the original data of the 16th (2020) online survey of youth health behavior in Korea, Frequency analysis, complex sample cross-analysis, complex sample logistic regression analysis were conducted using the SPSSwin 21.0 program. Results: As a result of the study, was associated with the consumption of all sweet drinks, fast food intake, and the frequency of daily brushing over the past 7 days Teeth pain is noted with the consumption of soda, sweet drinks, fast food, and the frequency of daily brushing over the past 7 days. Gum bleeding is noted with the consumption of sweetened products, fast food intake, and the frequency of daily brushing over the past 7 days. Conclusions: Eating habits and oral health behaviors should be considered for the oral health management of middle and high school students. Specific measures should be sought to provide proper dietary education and systematic oral health education to improve the oral health of middle and high school students.

Prosthetic rehabilitation with digital implant planning for a minimally invasive surgery approach (디지털 임플란트 플래닝을 통한 최소침습 보철수복 증례)

  • Jeong, Areum;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.283-292
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    • 2022
  • For fixed prosthetic treatment using implants, implants must be placed in a suitable location for prosthetic treatment. During surgery, minimally invasive prosthetic restoration is possible using a flapless method using a surgical guide. The patient in this case was an 86-year-old male patient who wanted treatment due to discomfort when using conventional dentures. Due to systemic disease, the patient had difficulty using removable local dentures, so full dentures for the maxilla and fixed implants for the mandible were restored. Because there is a high risk of bleeding due to systemic disease, the implant was placed in a flapless method using a surgical guide. Finally, prostheses were fabricated with maxillary full denture and mandibular screw-retained zirconia, and this report shows satisfactory esthetic and functional recovery.

2005~2006 Nationwide Gastric Submucosal Tumor Report in Korea (2005~2006년 전국 위점막하종양 설문조사 결과 보고)

  • The Information Committee of the Korean Gastric Cancer Association,
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.104-109
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    • 2008
  • Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

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Effects of the Short-Term Weight Control Program on Periodontal Health in the University Students: A Pilot Study (일개 대학생의 단기 체중조절 프로그램이 치주건강에 미치는 영향: 사전연구)

  • Koong, Hwa-Soo;Son, Soo-Jung;Park, Hoo-Seob;Seo, Hyung-Seok;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.413-418
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    • 2015
  • Recent cross-sectional studies indicate that obesity is a risk factor for periodontal disease. This study was aimed to investigate whether the four-week weight control program including caloric restriction and exercise training could have an effect on periodontal health. Forty-one obese (body mass index [BMI] ${\geq}25.0$) and five overweight ($23.0{\leq}BMI<25.0$) students participated in the weight control program. Anthropometric data and oral examination data were collected at the baseline and at the 27th day. BMI, waist hip ratio (WHR), and percent of body fat (PBF) of the subjects decreased significantly, but gingival index, sites with bleeding on probing (BOP), and sites with shallow pocket depth didn't show the significant changes in paired t-test. There was no difference in the outcomes according to smoking, drinking alcohol, and sex. Nevertheless, PBF and sites with BOP (r=0.777) and WHR and sites with shallow pocket depth (r=0.444) showed positive correlations. PBF accounted for 58.9% of the variance in sites of BOP in regression analysis. We suggested that obesity might relate with periodontal health, although it was not clear whether weight control could influence on periodontal health directly.