• 제목/요약/키워드: anticoagulants

검색결과 129건 처리시간 0.021초

항응고치료 환자에서 자발성 후복막강 출혈로 나타난 난소동맥 파열: 색전술을 이용한 성공적 치료 (Ovarian Artery Rupture Presenting with a Spontaneous Retroperitoneal Hemorrhage of an Anticoagulated Patient: A Successful Treatment with Embolization)

  • 이소정;최민정;김봉만;김상윤
    • 대한영상의학회지
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    • 제81권6호
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    • pp.1453-1458
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    • 2020
  • 후복막강 출혈은 항응고 치료의 치명적 합병증일 수 있으며, 나이 및 산과력과 상관없이 난소동맥이 출혈 병소일 수 있다. 저자들은 폐경기 여성에서 항응고 치료 중에 발생한 난소동맥 출혈을 경도관 혈관조영술 및 색전술을 통해 정확한 진단 및 효과적인 지혈이 가능했던 증례를 소개하고자 한다.

기초간호자연과학의 병태생리학, 병원미생물, 약물의 기전과 효과 내용별 필요도에 대한 연구 (A study on the degree of need of the knowledge of pathophysiology, clinical microbiology and mechanisms and effects of drugs in clinical nurses)

  • 최명애;변영순;서영숙;황애란;김희승;홍해숙;박미정;최스미;이경숙;서화숙;신기수
    • Journal of Korean Biological Nursing Science
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    • 제2권1호
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    • pp.1-19
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    • 2000
  • The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.

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쇽 혹은 우심실부전을 보이는 중증 폐혈전색전증에서 혈전용해요법과 항응고요법의 효과 (Comparison of Effect Between Thrombolysis and Anticoagulation in Major Pulmonary Thromboembolism)

  • 한송이;송재관;이상도;임채만;고윤석;박찬선;오연목;심태선;김우성;김동순;김원동;홍상범
    • Tuberculosis and Respiratory Diseases
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    • 제59권5호
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    • pp.487-496
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    • 2005
  • 연구배경 : 우심실부전 또는 쇽을 보였던 중증 폐색전증에서 혈전용해요법 혹은 항응고요법을 시행했을 때 예후의 차이에 대해 조사해 보고자 하였다. 방 법 : 1995년 1월부터 2004년 12월까지 서울아산병원에 입원했던 폐색전증 환자 중에서 우심실부전 혹은 쇽이 있었던 총 60명의 환자를 대상으로 의무기록 분석을 통해서 후향적으로 조사하였다. 결 과 : 총 57명의 환자가 혈전용해요법 또는 항응고요법을 시행 받았으며, 이 중 혈전용해제는 13명(23%)에서, 항응고제는 44명(77%)에서 사용되었다. 혈전용해요법 군과 항응고요법 군에서 APACHEII 점수나 SOFA 점수에 차이는 없었고 사망률은 각각 46% (6/13), 16% (7/44)였다(p=0.054). 쇽이 있는 19명(33%)의 환자 중 혈전용해요법은 9명(47%), 항응고요법은 10명(53%)에서 시행되었고 사망률은 각각 44% (4/9), 30% (3/10)로 차이가 없었다(p=0.650). 38명(67%)의 우심실부전 군에서 혈전용해요법은 4명(11%), 항응고요법은 34명(89%)에서 시행되었고 사망률은 50% (2/4), 24% (8/34)로 차이가 없었다(p=0.279). 중요 출혈부작용은 혈전용해요법 군과 항응고요법 군에서 23% (3/13), 5% (2/44)로 혈전용해요법이 높은 경향을 보였다(p=0.072). 결 론 : 중증 폐혈전색전증 환자에서 쇽 군과 우심실부전군을 각각 혈전용해요법과 항응고요법으로 치료했을 때, 두 군 모두에서 혈전용해요법이 항응고요법에 비해 사망률을 감소시키지 못했으며, 출혈부작용은 높은 경향을 보였다. 그러므로 우리나라에서 전향적 대규모 연구가 필요할 것으로 사료된다.

한방병원에 입원한 뇌경색 환자의 기능회복과 관련된 특성에 대한 연구 (The Study about Characteristics Affecting Functional Recovery of Stroke Patients Treated in an Oriental Medical Center)

  • 김영지;김미영;이승엽;최원우;박주영;권승원;정우상;문상관;조기호;김영석;박성욱;박정미;고창남;배형섭;나병조
    • 대한한방내과학회지
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    • 제30권4호
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    • pp.719-731
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    • 2009
  • Objectives : Stroke is the most common disabling neurological disease of adult life. The treatment and rehabilitation of stroke patients is an important and challenging area in the field of medicine. In Korea, a lot of stroke patients are treated using oriental medicine and there have been reports on their functional recovery. The aim of this study was to prove the therapeutic effect of oriental medicine on ischemic stroke. We also tried to identify characteristics of patients whose functional recovery was prominent and studied whether or not the use of fluids, anticoagulants, antiplatelets and neuroprotective agents increased the functional recovery of patients. Methods : We studied 794 patients within 2 weeks after first attack of ischemic stroke who were admitted to Kyung-Hee Oriental Medical Center from 1999 to 2000. Their maximum admission period was 60 days. Results : Motor power grade, NIHSS and MBI scores of patients improved during hospitalization significantly. Factors affecting functional recovery were admission period, motor power grade, NIHSS and MBI at admission. Age, waist-hip ratio and HDL cholesterol also affected functional recovery of patients. Whether or not fluids, anticoagulants, antiplatelets and neuroprotective agents were administered had nothing to do with functional recovery. Conclusion : Oriental medicine is effective for treatment and rehabilitation of ischemic stroke patients. When we manage stroke, we have to consider some important factors.

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경사관법(傾斜管法)에 의한 우혈액(牛血液)의 적혈구침강율(赤血球沈降率) 측정(測定) (Angled Tube Method for Determining Erythrocyte Sedimentation Rate of Cattle)

  • 이방환;신종욱
    • 대한수의학회지
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    • 제26권1호
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    • pp.175-185
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    • 1986
  • The measurement of angled erythrocyte sedimentation rate (ESR), as a replacement for perpendicular ESR, for cattle blood was scrutinized since it has been well known that perpendicular ESR in cattle is too slow to be adopted as an effective clinical test. Samples of blood were taken from 186 Korean native cattle over 2 years old. The results obtained in the experiment were summarized as follows. 1. Average values of perpendicular ESR/24hrs in 15 apparently healthy cattle, as measured by Wintrobe, Westergren and capillary tubes, were $5.8{\pm}2.2$, $11.1{\pm}3.7$ and $10.4{\pm}4.5%$ respectively, which were found to be similar to the values of perpendicular ESR/hr of normal blood of human. 2. The ESR was determined in the tubes held at 90, 75, 60, 45, 30 and 15-degree angles, using 3 types of tubes. For the diagnostic purposes, the best results were obtained from the tubes held at 45-degree angle. 3. The angled ESR values increased as the diameters of the tube-bores decreased. 4. The tube length did not affect the angled ESR(%). 5. The angled ESR values increased with the increased environmental temperature during the ESR measurement. 6. The storage temperature at $5^{\circ}C$, $20^{\circ}C$ and $35^{\circ}C$, of the blood for 24 hours did not affect the angled ESR. 7. Samples of blood were treated with 4 kinds of anticoagulants (heparin, $K_2$-EDTA, double oxalate and sodium citrate) and the ESR was determined at 45-degree angle, using capillary hematocrit tubes. The ESR values were higher in the blood samples treated with sodium citrate than in those treated with other anticoagulants. 8. By using the autologous plasma, the PCV was adjusted to be 5, 10, 20, 30, 40 and 50ml/100ml and the ESR was determined in the capillary hematocrit and Wintrobe tubes held at 45 degrees. In both of the methods the ESRs increased as the values of PCV decreased. The regressions of ESR to PCV in both 45-degree-angled capillary and Wintrobe tubes were curvilinear. For the capillary hematocrit tubes the second degree polynomial $Y=61.9779-2.3533x+0.0228x^2$ (r=0.9999) fits the data. And in the case of Wintrobe tubes the second degree polynomial $Y=27.9767-1.1314x-0.0117x^2$ (r=0.9998) fits the data. 9. The 45-degree angled ESR was determined in the blood of 71 healthy Korean native cows using capillary hematocrit tubes. The average PCV was $35.4{\pm}3.6ml/100ml$. The observed ESR/hr averaged $7.2{\pm}2.7%$, while the corrected ESR/hr to a PCV of 36ml/100ml averaged $6.6{\pm}1.3%$. From these results it was concluded that to obtain the best results the ESR/hr of Korean native cattle should be determined at 45-degree angle at room temperature($20^{\circ}C$) using capillary hematocrit tubes.

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Guidelines for Transrectal Ultrasonography-Guided Prostate Biopsy: Korean Society of Urogenital Radiology Consensus Statement for Patient Preparation, Standard Technique, and Biopsy-Related Pain Management

  • Myoung Seok Lee;Min Hoan Moon;Chan Kyo Kim;Sung Yoon Park;Moon Hyung Choi;Sung Il Jung
    • Korean Journal of Radiology
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    • 제21권4호
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    • pp.422-430
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    • 2020
  • The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

허혈성 뇌졸중에서의 항혈전 치료 (Antithrombotic Therapy for Ischemic Stroke)

  • 하정상;이준
    • Journal of Yeungnam Medical Science
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    • 제20권1호
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    • pp.1-12
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    • 2003
  • Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

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방사선학적으로 확진된 신증후군과 동반된 신정맥 혈전증 1예 (A Case of Renal Vein Thrombosis Associated with Nephrotic Syndrome)

  • 정경화;변우목;장재천
    • Journal of Yeungnam Medical Science
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    • 제4권2호
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    • pp.179-184
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    • 1987
  • 저자들은 신증후군의 증상으로 본 영남대학교 의과대학 부속병원에 내원한 환자에서 임상증상과 임상검사 소견 및 초음파, 신주사, 신동맥조영술 등의 소견으로 신정맥 혈전증을 의심하였고 신정맥조영술을 시행하여 신증후군과 동반된 신정맥 혈전증임이 확진된 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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Detection of Heparin in the Salivary Gland and Midgut of Aedes togoi

  • Ha, Young-Ran;Oh, So-Ra;Seo, Eun-Seok;Kim, Bo-Heum;Lee, Dong-Kyu;Lee, Sang-Joon
    • Parasites, Hosts and Diseases
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    • 제52권2호
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    • pp.183-188
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    • 2014
  • Mosquitoes secrete saliva that contains biological substances, including anticoagulants that counteract a host's hemostatic response and prevent blood clotting during blood feeding. This study aimed to detect heparin, an anticoagulant in Aedes togoi using an immunohistochemical detection method, in the salivary canal, salivary gland, and midgut of male and female mosquitoes. Comparisons showed that female mosquitoes contained higher concentrations of heparin than male mosquitoes. On average, the level of heparin was higher in blood-fed female mosquitoes than in non-blood-fed female mosquitoes. Heparin concentrations were higher in the midgut than in the salivary gland. This indicates presence of heparin in tissues of A. togoi.

침술에 발병된 내경정맥 혈전증 - 1예 보고 - (Internal Jugular Vein Thrombosis Secondary to Acupuncture - A case report-)

  • 이석열;이승진;이철세
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.778-780
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    • 2010
  • 48세 여자 환자가 좌측 팔의 통증으로 1개월간 한의원에서 침술치료를 받던 중 좌측 경부의 부종과 통증으로 내원하였다. 컴퓨터 촬영상 좌측 내경정맥 혈전증이 발견되었다. 환자는 항생제와 함께 항응고 치료를 받고는 증세 호전이 되어 현재 통원 치료 중이다. 침술치료에 따른 내경정맥 혈전증은 아직 증례보고가 없는 바 이에 문헌고찰과 함께 보고하는 바이다.