• Journal of Korean Neurosurgical Society
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• 제57권2호
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• pp.114-118
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• 2015

Objective : Venous thromboembolism (VTE) after spinal surgery affects a patients' postoperative recovery and also carries a mortality risk. Some studies recommended chemical prophylaxis for high-risk patients and for those after complex spinal surgeries. However, chemoprophylaxis for VTE in spinal surgery is underemployed and there is no agreement on the use of VTE prophylaxis in spinal surgery. The aim of this study was to document the incidence of VTE after an elective instrumental spinal surgery, among those receiving preoperative chemoprophylaxis as compared with patients who did not receive it. Methods : This study was carried out on eighty-nine patients allocated randomly to receive either low molecular weight heparin (LMWH) or no prophylaxis before elective instrumental spinal surgery. All patients received postoperative compression stockings. A compression Doppler ultrasonography was performed for all patients to detect postoperative deep vein thrombosis. In addition, further imaging studies were performed for patients suspected of VTE. Results : Three (3.3%) patients were diagnosed with VTE. One of them had received preoperative chemoprophylaxis. There were no significant difference in incidence of VTE between the two groups (p>0.95; 95% confidence interval, 0.06-8.7). Laterality of gender and postsurgical recumbence duration were all independent predictors of VTE (p=0.01 and p<0.001, respectively). Conclusion : The difference in the incidence of thromboembolic complications between the two groups was not significant. Moreover, we found that preoperative prophylactic LMWH injection has no major bleeding complications altering postoperative course; still, the issue concerning the initiation time of chemoprophylaxis in spinal surgery remains unclear.

• Journal of Chest Surgery
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• 제53권6호
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• pp.381-386
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• 2020

Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

• 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.

• 재활복지공학회논문지
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• 제11권2호
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• pp.125-132
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• 2017

환자의 혈전증 예방을 위하여 사지압박순환장치가 사용되어지고 있으나 잦은 고장으로 인한 불만이 많다. 이에 본 연구에서는 사지압박순환장치의 고장의 발생 원인을 파악하고 제품요인, 간호사요인, 환자요인 그리고 시스템요인에 대하여 다양한 개선 활동을 시행하였다. 그 결과로 각각의 요인에 대한 지표의 개선효과를 볼 수 있었으며, 기기의 불량률을 줄일 수 있었다. 보다 적극적인 의료기기의 개선 활동은 기기의 불량률을 줄이는데 기여할 수 있으며, 이를 통해 의료 서비스의 품질 개선 및 안전한 의료문화를 이루는데 도움이 될 수 있을 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.394-399
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• 1999

저자들은 갑작스런 흉통을 주소로 내원한 젊은 남자에서 AT III 결핍증에 의한 폐색전증을 진단하고 세 자녀 모두에서도 AT III 결핍이 확인됨으로써 폐색전증을 동반한 선천성, 가족성 AT III 결핍증을 경험하였기에 문헌고찰과 함께 보고한다.

• Korean Journal of Radiology
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• 제1권1호
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• pp.38-42
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• 2000

Objective: The purpose of this study was to determine the utility of preoperative CT in predicting early recurrence of hepatocellular carcinoma after partial hepatic resection. Materials and Methods: Preoperative three-phase helical CT scans in 53 patients with hepatocellular carcinoma were retrospectively reviewed by two radiologists. In 27 patients (group I), HCC had recurred within six months, while 26 (group II) had remained disease free for at least two years. In each group, preoperative CT findings were evaluated in each group for the tumor size and number, the presence or absence of capsule, distinctness of tumor margin, perinodular extension, and the presence or absence of portal vein thrombosis. Results: In group I, a tumor capsule of tumor was seen in five of 27 patients (19%), and in group II, in 16 of 26 (62%) (p = .001). The tumor margin was distinct in eight patients (30%) in group I and in 20 (77%) in group II (p = .001). Multiple tumors, perinodular extension, and portal vein thrombosis were more frequently seen in group I but the differences were not statistically significant (p > .05). Tumor size was similar in each group (p > .05). Conclusion: Preoperative CT findings that may help predict the early recurrence of hepatocellular carcinoma after surgical resection are an absence of capsule of tumors and an indistinct margin. Reference to these findings during preoperative CT can guide clinicians in their choice of treatment.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.57-62
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• 2005

Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

• 근관절건강학회지
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• 제19권2호
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• pp.184-196
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• 2012

Purpose: This study aimed to investigate the degree of discomfort and to identify factors related with discomfort in patients wearing thigh-length compression stockings after orthopedic surgery. Methods: The participants were 105 patients wearing thigh-length compression stockings after orthopedic surgery at two hospitals in B city. Data were collected by the scale of discomfort in wearing compression stockings from July 5 to October 20, 2011. Results: Mean score of discomfort on wearing compression stockings was significantly higher at post-op. day 3 than day 1 (t=-2.30, p=.004). Discomfort scores for 'itching skin' and 'tightened leg' items were higher than others. There was significant difference in discomfort at post-op. day 1 according to surgical regions. The total score of discomfort at post-op. day 3 was positively related with the body mass index (r=.20, p=.041). Conclusion: Wearing thigh-length compression stockings to prevent deep vein thrombosis may cause physical and psychological discomfort for orthopedic surgical patients. To reduce discomfort in wearing compression stockings, nurses need to intervene discomfort and problems related to the stockings post-operatively.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.214-217
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• 2018

Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.34-37
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• 2014

Hypercoagulability disorders are commonly encountered in clinical situations in patients with a variety of cancers. However, several hypercoagulability disorders presenting as first symptoms or signs in cancer patients have rarely been reported. We herein described a case of a woman with adenocarcinoma of the lung presenting with deep vein thrombosis, nonbacterial thrombotic endocarditis, recurrent cerebral embolic infarction, and heart failure.