• Title/Summary/Keyword: active bleeding

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Unusual MR Features of Extravasation of Contrast Material in Hyperacute Intracerebral Hemorrhage (초급성 두개내 출혈 환자에서 조영제의 혈관외 누출을 동반한 비전형적 자기공명영상)

  • Choi Seung Hong;Chun Woo Sun;Kim Ji-Hoon;Kang Hyun Seung;Kwon Bae Ju;Na Dong Gyu;Kim Jae Hyung;Han Moon Hee;Chang Kee-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.50-56
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    • 2005
  • Contrast extravasation in hyperacute intracerebral hemorrhage (ICH) indicative of active bleeding is a predictor of possible enlargement of hematoma, providing clinician with valid management decisions. We report unusual MR imaging features of contrast extravasation in hyperacute ICH in three patients: Case 1 with hypertension revealed dual foci of contrast extravasation, one in right basal ganglia and the other in left lateral ventricle, suggesting simultaneous bleeding of the two foci. Case 2 with presumed diagnosis of vasculitis showed relatively large area of contrast extravasation mimicking enhancing tumor or vascular lesion. Case 3 with hypertension showed the findings of active bleeding which was likely to occur during the time of MR imaging acquisition.

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The Outcomes of Treatment for Sacrococcygeal Teratoma: The 24-year Experiences (엉치꼬리 기형종에 대한 24년 간의 치료 경험 분석)

  • Gong, C.S.;Kim, S.C.;Kim, D.Y.;Kim, I.K.;Namgung, J.M.;Hwang, J.H.;Kim, J.J.
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.81-89
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    • 2013
  • The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

Spontaneous Intracranial Epidural Hematoma Originating from Dural Metastasis of Hepatocellular Carcinoma

  • Kim, Byoung-Gu;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.166-169
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    • 2010
  • Spontaneous intracranial epidural hematoma (EDH) due to dural metastasis of hepatocellular carcinoma is very rare. A 53-year-old male patient with hepatocellular carcinoma, who was admitted to the department of oncology, was referred to department of neurosurgery because of sudden mental deterioration to semicoma with papillary anisocoria and decerebrate rigidity after transarterial chemoembolization for hepatoma. Brain computed tomography (CT) revealed large amount of acute EDH with severe midline shifting. An emergent craniotomy and evacuation of EDH was performed. Active bleeding from middle cranial fossa floor was identified. There showed osteolytic change on the middle fossa floor with friable mass-like lesion spreading on the overlying dura suggesting metastasis. Pathological examination revealed anaplastic cells with sinusoidal arrangement which probably led to spontaneous hemorrhage and formation of EDH. As a rare cause of spontaneous EDH, dural metastasis from malignancy should be considered.

Unusual Presentation of a Penetrating Aortic Arch Injury

  • Vural, Fikret Sami;Patel, Atul Kumar;Mustafa, Kashif
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.295-297
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    • 2017
  • A 27-year-old man was admitted with a penetrating injury at the mid-manubrium. Computed tomographic (CT) angiography showed a f illing def ect in the aortic arch. This was evaluated as a sign of injury and the patient underwent an emergency operation. No active bleeding or clot was f ound in the mediastinum during the operation. The laceration point was between the innominate and the left carotid artery posteriorly. The injury was approached using hypothermic circulatory arrest. Aortotomy and exploration showed a 2-cm-long full-thickness aortic injury with an overlying clot. A filling defect on angiography as a sign of a penetrating arch injury has never been reported previously, but was the main pathological finding on CT angiography in our case. The aorta is a high-pressure system and injuries to it should be treated aggressively.

$^{18}F-FDG-PET/CT$ in Endometrial Carcinoma (자궁내막암에서 $^{18}F-FDG-PET/CT$)

  • Jeon, Tae-Joo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.110-112
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    • 2008
  • Endometrial carcinoma is one of the most common gynecologic malignancies and which is predominant in postmenopausal women. Clinically many patients are hospitalized in early stage due to clinical sign and symptom such as vaginal bleeding and in this case, patient's prognosis is known to be good. However, considerable number of patients with advanced and relapsed disease reveal poor prognosis. Therefore, exact staging work up is essential for proper treatment as is primary lesion detection. $^{18}F-FDG-PET$ has been widely used for the evaluation of gynecologic malignancies such as cervical carcinoma and ovarian cancer. In contrast, FDG PET application to endometrial carcinoma is limited until now and there is no sufficient data to validate the usefulness of FDG PET for this disease yet. However, several studies showed promising results that FDG PET is sensitive and specific in detection of recurrent or metastatic lesions. Therefore further active investigation in this field can facilitate the use of FDG PET for endometrial carcinoma.

Antiinflammatory Evaluation and Synthesis of Benzothiazine Derivatives as Cyclooxygenase-2 Inhibitor (Cyclooxygenase-2 저해제로서의 benzothiazine 유도체 합성과 항염작용 평가)

  • 신혜순;박명숙;권순경
    • YAKHAK HOEJI
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    • v.44 no.3
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    • pp.272-278
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    • 2000
  • The antiinflammatory mechanism of NSAIDs is attributed to the reduction of prostaglandin synthesis by the direct inhibition of cyclooxygenase. Inhibition of prostaglandin production in organs such as stomach and kidney can result in gastric lesions, nephrotoxicity and increased bleeding. In this study, newly designed COX-2 inhibitors, synthesized 1,2-benzothiazine derivatives, were screened in vitro for selectivity of COX-1 and COX-2 inhibition properties. Lead compounds in the structure-activity relationship were studied to synthesize new highly selective COX-2 inhibitors.13 determine inhibitory effect of COX-2, synthesized 1,2-benzothiazine derivatives were screened with accumulation of prostaglandin by lipopolysaccharide (LPS) in aspirin-treated macrophages and murine macropharge cell. Some of synthesized 1,2-benzothiazine derivatives were shown to be effective as selective COX-2 inhibitory activity. Others exhibited a preferential inhibition of COX-2, although some COX-1 inhibitory activity was still present. As a conclusion, simple monomer derivatives were more active than dimer derivatives. Substitution of halogen (Br, C1) on the benzothiazine nucleus slightly enhanced inhibition activity.

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Early Surgical Intervention of Active Infective Endocarditis (심내막염 환자의 수술적 치료)

  • 박국양
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.121-130
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    • 1988
  • During one year period from Sep. 1986 to Sep. 1987, we have experienced 6 cases of infective endocarditis requiring surgical interventions. All 6 patients had class IV or V cardiac disability at the time of surgery. The indication for surgery was rapidly progressive congestive heart failure in all cases. Four patients underwent aortic valve replacement including one double valve replacement. Two other patients required other surgical procedures, removal of large left atrial vegetation mass in one patient and excision of destroyed pulmonary valve and aortic vegetation in the other patient. Two patients died; one of mitral annulus rupture after release of aortic clamp and the other of mediastinal bleeding 3 months after replacement of aortic valve. Three out of 4 survivors are in NYHA Class I and the remaining patient is in Class II. We emphasize that early operative intervention is life-saving in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy.

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Present State and Prospect of Starch Sugar (전분단의 현황과 전망)

  • 임번삼;황두연
    • Korean Journal of Microbiology
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    • v.15 no.1
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    • pp.46-59
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    • 1977
  • To screen biologically active components of the higher fungi of Korea, the carpophores of Auricularia polytricha, a well-known edible mushroom, were extracted with 0.14M NaCl solution. The extractive was successively fractionated by adding ammonium sulfate in various amounts, the respective precipitates being weparated by centrifugation, dialyzed and freeze-dried. When a dose of 60mg/kg of each was, i.p., injected into ICR mice, the fraction shich was precopitated at 20% (NH$_{4}$)$_{2}$SO$_{4}$ showed the highest toxicity, killing seven mice within two days. The fraction obtained at 40% (NH$_{4}$)$_{2}$SO$_{4}$ showed the second highest toxicity. The two fractions were named auratoxin I and II after the genus name. The symptoms of the intoxication were convulsion during the first 30 minutes after the injection, then sleeping within an hour, and tremor, lacrimation, nasal and ophthalmic bleeding, congestion and death in 24 hours. Particularly the spleen of the mice was fonud to be enlarged remarkably. The chemical analysis of the toxins showed that auratoxin I consisted of 4.4% protein and 84.5% polysaccharide and that auratoxin II 35.8% protein and 48.0% polysaccharide.

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Studies on the toxicity of auricularia polytricha (털목이버섯의 독성에 관한 연구)

  • 김하원;최응칠;김병각
    • Korean Journal of Microbiology
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    • v.22 no.4
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    • pp.223-228
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    • 1984
  • To screen biologically active components of the higher fungi of Korea, the carpophores of Auricularia polytricha, a well-known edible mushroom, were extracted with 0.14M NaCl solution. The extractive was successively fractionated by adding ammonium sulfate in various amounts, the respective precipitates being weparated by centrifugation, dialyzed and freeze-dried. When a dose of 60mg/kg of each was, i.p., injected into ICR mice, the fraction shich was precopitated at 20% (NH/sub 4/)/sub 2/SO/sub 4/ showed the highest toxicity, killing seven mice within two days. The fraction obtained at 40% (NH/sub 4/)/sub 2/SO/sub 4/ showed the second highest toxicity. The two fractions were named auratoxin I and II after the genus name. The symptoms of the intoxication were convulsion during the first 30 minutes after the injection, then sleeping within an hour, and tremor, lacrimation, nasal and ophthalmic bleeding, congestion and death in 24 hours. Particularly the spleen of the mice was fonud to be enlarged remarkably. The chemical analysis of the toxins showed that auratoxin I consisted of 4.4% protein and 84.5% polysaccharide and that auratoxin II 35.8% protein and 48.0% polysaccharide.

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Penetrating Chest Trauma in Autopneumonectomy Status due to Pulmonary Tuberculosis : 1 Case Report (폐결핵에 의한 전폐자가절제 환자에서의 흉부 자상 치험 1례-)

  • Hong, Yoon Joo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.89-93
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    • 2005
  • Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

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