• 제목/요약/키워드: VTE

검색결과 48건 처리시간 0.023초

Incidence of Venous Thromboembolism after Primary Total Hip Arthroplasty with Mechanical Prophylaxis in Hong Kong Chinese

  • Daniel Wai-Yip Wong;Qunn-Jid Lee;Chi-Kin Lo;Kenneth Wing-Kin Law;Dawn Hei Wong
    • Hip & pelvis
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    • 제36권2호
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    • pp.108-119
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    • 2024
  • Purpose: The incidence of deep vein thrombosis (DVT) following total hip arthroplasty (THA) without chemoprophylaxis could be as high as 50% in Caucasians. However, according to several subsequent studies, the incidence of venous thromboembolic events (VTE) in Asians was much lower. The routine use of chemoprophylaxis, which could potentially cause increased bleeding, infection, and wound complications, has been questioned in low-incidence populations. The objective of this study is to determine the incidence of VTE after primary THA without chemoprophylaxis in an Asian population using a fast-track rehabilitation protocol and to verify the safety profile for use of 'mechanical prophylaxis alone' in patients with standard risk of VTE. Materials and Methods: This is a retrospective cohort study of 542 Hong Kong Chinese patients who underwent primary THA without chemoprophylaxis. All patients received intermittent pneumatic compression and graduated compression stockings as mechanical prophylaxis. Multimodal pain management was applied in order to facilitate early mobilisation. Routine duplex ultrasonography was performed between the fourth and seventh postoperative day for detection of proximal DVT. Results: All patients were Chinese (mean age, 63.0±11.9 years). Six patients developed proximal DVT (incidence rate, 1.1%). None of the patients had symptomatic or fatal pulmonary embolism. Conclusion: The incidence of VTE after primary THA without chemical prophylaxis can be low in Asian populations when following a fast-track rehabilitation protocol. Mechanical prophylaxis alone can be regarded as a reasonably safe practice in terms of a balanced benefit-to-risk ratio for Asian patients with standard risk of VTE.

Theoretical Study of Scanning Probe Microscope Images of VTe2

  • Park, Sung-Soo;Lee, Jee-Young;Lee, Wang-Ro;Lee, Kee-Hag
    • Bulletin of the Korean Chemical Society
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    • 제28권1호
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    • pp.81-84
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    • 2007
  • Ab initio periodic Hartree-Fock calculations with the full potential and minimum basis set are applied to interpretation of scanning tunneling microscope (STM) and atomic force microscope (AFM) images on 1TVTe2. Our results show that the simulated STM image shows asymmetry while the simulated AFM image shows the circular electron densities at the bright spots without asymmetry of electron density to agree with the experimental AFM image. The bright spots of both the STM and AFM images of VTe2 are associated with the surface Te atoms, while the patterns of bright spots of STM and AFM images are different.

The Incidence of Venous Thromboembolism Following Shoulder Surgery: A Pilot Study

  • Cho, Chul-Hyun;Jang, Hyung-Gyu;Park, Ui-Jun;Kim, Hyoung Tae
    • Clinics in Shoulder and Elbow
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    • 제20권1호
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    • pp.18-23
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    • 2017
  • Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

Clinical Outcomes of a Preoperative Inferior Vena Cava Filter in Acute Venous Thromboembolism Patients Undergoing Abdominal-Pelvic Cancer or Orthopedic Surgery

  • Kim, Hakyoung;Han, Youngjin;Ko, Gi-Young;Jeong, Min-Jae;Choi, Kyunghak;Cho, Yong-Pil;Kwon, Tae-Won
    • Vascular Specialist International
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    • 제34권4호
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    • pp.103-108
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    • 2018
  • Purpose: Surgery is the most common risk factor for pulmonary embolism (PE) in patients with a recent venous thromboembolism (VTE). This study reviewed clinical outcomes of preoperative inferior vena cava filter (IVCF) use in patients with acute VTE during abdominal-pelvic cancer or lower extremity orthopedic surgeries. Materials and Methods: We retrospectively analyzed 122 patients with a recent VTE who underwent IVCF replacement prior to abdominal-pelvic cancer or lower extremity orthopedic surgery conducted between January 2010 and December 2016. Demographics, clinical characteristics, postoperative IVCF status, risk factors for a captured thrombus, and clinical outcomes were collected for these subjects. Results: Among the 122 study patients who were diagnosed with acute VTE in the prior 3 months and underwent preoperative IVCF replacement, 70 patients (57.4%) received abdominal-pelvic cancer surgery and 52 (42.6%) underwent lower extremity orthopedic surgery. There were no perioperative complications associated with IVCF in the study population and no cases of symptomatic PE postoperatively. A captured thrombus in the filter was identified postoperatively in 16 patients (13.1%). Logistic regression analysis indicated that postoperative anticoagulation within 48 hours significantly reduced the risk of a captured thrombus (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08-0.94; P=0.032). Conclusion: A captured thrombus in preoperative IVCF was identified postoperatively in 16 patients (13.1%). Postoperative anticoagulation within 48 hours reduces the risk of captured thrombus in these cases.

안면견갑상완형 근이영양증 환자에 대한 한의학적 치료 이후 호흡기능 호전에 대한 임상 증례 (A Clinical Case Report on the Improvement of Respiratory Function of a Fascioscapulohumeral Muscular Dystrophy Patient after Korean Medical Treatment)

  • 이상현;정주용;조명래
    • Journal of Acupuncture Research
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    • 제32권4호
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    • pp.195-201
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    • 2015
  • Objectives : The purpose of this study is to report on the improvement of respiratory function of a fascioscapulohumeral muscular dystrophy patient after receiving Korean medical treatment. Methods : This study was carried out on a 60 year-old male patient who suffered from fascioscapulohumeral muscular dystrophy. While we carried out Korean medical treatment, we observed $EtCO_2$ (end-tidal carbon dioxide), Vte (exhaled tidal volume) and PIP (peak inspiratory pressure). Results : $EtCO_2$ count decreased from 34 mmHg to 24 mmHg during the treatment period, and PIP count became stable. Vte count also did not worsen in this study. Conclusions : Based on this study, we concluded that Korean medical treatment could be effective in treating fascioscapulohumeral muscular dystrophy patients with respiratory failure.

엽록체 지질 소기관의 기능과 지질대사에서의 역할 (Plastoglobule in chloroplast and its role in prenylquinone metabolism)

  • 김현욱;김은하;이경렬;정수진;노경희;김종범
    • Journal of Plant Biotechnology
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    • 제40권3호
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    • pp.125-134
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    • 2013
  • 최근 연구에서 엽록체의 미지의 소기관으로 알려졌던 플라스토글로뷸이 지질 대사에서 중요한 역할을 함이 제시되고 있다. 애기장대 플라스토글로뷸의 프로테옴 단백질 분석은 플라스토글로뷸이 단순히 지질 저장 기관으로써의 기능 뿐아니라 지질 합성 대사에 능동적으로 관여하는 소기관임을 제시하고 있다. 애기장대 플라스토글로뷸에서 34개의 단백질이 발견되었다. 이들을 세 그룹으로 나누어 보면 구조단백질인 플라스토글로불린과 엽록체 대사에 관여하는 효소, 그리고 기능이 미확인된 단백질로 구분 된다. 이들 단백질 유전자의 돌연변이체와 리피도믹스 분석으로 이들 단백질의 기능 규명 연구가 필요하다. 토코페롤 합성의 마지막 단계에 관여하는 VTE1과 VTE4는 엽록체에서 각기 다른 위치에 존재하여 VTE1은 플라스토글로뷸에 존재하나 VTE4는 엽록체 내막에 존재한다. 이 같은 사실은 프레닐퀴논 대사물질이 엽록체 내에서 이동할 가능성을 시사한다. 플라스토글로뷸이 엽록체의 기능을 유지하는데 있어 필수적인지에 대한 유전학 연구가 앞으로 진행되어야 한다. 다양한 스트레스와 발달단계에 따른 플라스토글로뷸의 프로테옴 분석은 지질대사에서 중요한 기능을 하는 신규 단백질을 발견하는데 도움을 줄 것이다. 지금까지 결과로는 플라스토글로뷸은 프레릴퀴논 대사에 있어서 교차로 역할을 함을 제안하고 있다.

Respiratory Review of 2013: Pulmonary Thromboembolism

  • Hwang, Hun Gyu;Schulman, Sam
    • Tuberculosis and Respiratory Diseases
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    • 제75권3호
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    • pp.89-94
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    • 2013
  • Pulmonary embolism (PE), which can originate as a consequence of deep vein thrombosis (DVT), is the most frequent and potentially fatal venous thromboembolic event. Despite the fact that the incidence of venous thromboembolism (VTE) in Asians is lower than that in the Western populations, a recent epidemiologic study demonstrates an increasing incidence of VTE in the Korean population. Anticoagulants, including low molecular weight heparin (LMWH) and vitamin K antagonist (VKAs), have been the main treatments for PE, however, recently new oral anticoagulants (NOACs) were introduced. We will review how well patients with PE can be managed with the existing anticoagulants and NOACs along with the time span of treatment, which still pose some challenges for clinicians.

Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk;Kang, Ji-Hoon;Kang, Sa-Yoon;Lee, Jung Seok;Song, Sook-Keun;Oh, Jung-Hwan;Kim, Joong-Goo;Han, Eun Young;Lee, Ho Kyu;Choi, Jay Chol
    • 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.

전이성 위암환자의 심부정맥혈전증에 대한 저분자량 헤파린 투여 사례 (A Case of Advanced Gastric Cancer with Deep Vein Thrombosis Treated with Low Molecular Weighted Heparin)

  • 허수진;박찬혁;이상길
    • 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.

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설사 증상의 돼지 분변에서 분리된 용혈성 대장균의 항생제 내성과 독소의 인체로부터 분리된 균주로의 전이 (Transfer of Genes for Antimicrobial Resistance and Toxin of Hemolytic Escherichia coli Isolated from Feces of Pig Suffering Diarrhea to Human Isolates)

  • 이계남;정병열;이연희
    • 미생물학회지
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    • 제40권4호
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    • pp.286-294
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    • 2004
  • 1997년과 1998년 사이에 설사 증상을 보이는 돼지의 분변으로부터 총56균주의 Escherichia coli를 분리하여 이중 용혈성을 나타내는 38균주의 항생제 내성과 독소 생산능을 확인하였다. 항생제 한천 희석법으로 최소억제농도(minimal inhibitory concentration)를 측정한 결과 36균주$(94.7\%)$가 tetracycline에 대해 내성을 나타내었고, 27주$(71.0\%)$는 ampicillin에 내성, 26균주$(68.4\%)$는 chloramphenicol에 내성, 그리고 21균주$(55.2\%)$는 tri-methoprim에 내성을 나타내었으나, aztreonam, amikacin, norfloxacin에 내성을 나타낸 균주는 발견되지 않았다. 이중 4가지 이상의 항생제에 대해 내성을 가지는 다제내성(multiple drug resistance, MDR)을 보인 균주는 총 38 균주 중 21균주$(55.3\%)$였다. 또한 이중 디스크 시험법(Double Disk Synergy Test)을 수행한 결과 extended spectrum $\beta-lactamase$를 생산하는 균주는 없는 것으로 나타났다. 이들 중 가장 많은 수의 균주가 내열성 독소$(ST,89.5\%)$를 생산하였고, 다음으로 베로 독소(VT와 VTe, 각각$47.4\%$)와 이열성 독소$(LT,31.6\%)$를 생산하는 것으로 나타났다. 이 중에서 8균주$(21.0\%)$는 57만을 생산하였던 반면에 12균주$(31.6\%)$는 LT와 ST를 동시에 생산하였고, 13균주$(34.2\%)$는 ST, VT, VTe를 동시에 생산하였으며, 5균주$(13.2\%)$는 VT와 VTe를 동시에 생산하는 것으로 나타났다. 그러나 네 가지 독소를 동시에 생산하는 균주는 없었다. 또한 이 균주들은 매우 다양한 혈청형(serotype)을 가지고 있음이 확인되었다. 사람에 직접적인 유해성을 가지고 있는 지 확인하기 위해 사람 방광 유래의 T-24세포와 장내 표피 유래의 Caco-2세포에 대한 부착능을 시험하였을 때, 16균주$(42.1\%)$가 T-24방광 세포에, 그리고 17균주$(44.7\%)$가 Caco-2장세포에 대해 강한 부착능을 나타내었다. 특히 11균주$(28.9\%)$는 두 세포 모두에 강한 부착능을 가지고 있었다. Filter mating method를 수행하여 이들 균주들의 독소 생산 유전자와 항생제 내성 유전자가 사람에서 분리된 균주로 전달되는 것을 확인할 수 있었다. 본 실험의 결과는 설사 중상을 나타내는 돼지로부터 분리된 용혈성 E. coli의 독성과 세포 부착능력, 그리고 항생제 내성간의 상호 연관성을 보여주지 않았으나 동물 분리 세균의 항생제 내성과 독소 생산 능력이 유전자 전달을 통해서 뿐만 아니라 세균의 직접 접촉에 의해서도 인체로 전달될 수 있는 것을 보여주는 것이다.