• Title/Summary/Keyword: bleeding risk

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Genome-Wide Association Study Identifies Candidate Loci Associated with Platelet Count in Koreans

  • Oh, Ji Hee;Kim, Yun Kyoung;Moon, Sanghoon;Kim, Young Jin;Kim, Bong-Jo
    • Genomics & Informatics
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    • v.12 no.4
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    • pp.225-230
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    • 2014
  • Platelets are derived from the fragments that are formed from the cytoplasm of bone marrow megakaryocytes-small irregularly shaped anuclear cells. Platelets respond to vascular damage, contracts blood vessels, and attaches to the damaged region, thereby stopping bleeding, together with the action of blood coagulation factors. Platelet activation is known to affect genes associated with vascular risk factors, as well as with arteriosclerosis and myocardial infarction. Here, we performed a genome-wide association study with 352,228 single-nucleotide polymorphisms typed in 8,842 subjects of the Korea Association Resource (KARE) project and replicated the results in 7,861 subjects from an independent population. We identified genetic associations between platelet count and common variants nearby chromosome 4p16.1 ($p=1.46{\times}10^{10}$, in the KIAA0232 gene), 6p21 ($p=1.36{\times}10^{-7}$, in the BAK1 gene), and 12q24.12 ($p=1.11{\times}10^{-15}$, in the SH2B3 gene). Our results illustrate the value of large-scale discovery and a focus for several novel research avenues.

Incidence of the Needle-Stick Injuries in Medical Students Among Clinical Training (임상실습(臨床實習)중인 의과대학생(醫科大學生)들의 주사침(注射針) 상해(傷害)(needle-stick injury) 발생율(發生率))

  • Park, Wan-Seoup;No, Yun-Kyung;Lee, Jong-Young;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.403-409
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    • 1994
  • A questionnaire survey wds conducted to assess the experience of the needle stick injury in 144 seniors of a medical school during the previous 10 months. One hundred and five of them (73%) had responded. About sixty-nine percent (72 cases) of the respondents had suffered at least one u and there had been 129 injuries in total. Seventy-eight (56.6%) of the injuries took place at the time of the venipuncture. The emergency and operating room incurred 76.7% and 23.3% of the injury, respectively. Injuries with bleeding account for 50.4%. None of the respondents was systematically educated about the prevention of injury. This survey shows that the needle-stick Injury is a great risk for the medical students' health, and that educational effort for its prevention is warranted.

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Early-stage Diagnosis of Bladder Carcinoma by a Clinical Pharmacist's Effective Anti-coagulation Service in a Patient with Anticoagulation Therapy: a Clinical Case Report (항응고제 투여 환자에서 약사의 효과적인 ACS를 통한 방광암 조기발견 사례)

  • An, Sung-Shim;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.85-87
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    • 2010
  • Recently, the prevalence of bladder cancer is increasing in the Korean society. As the risk factors of bladder carcinoma are variable, the early-stage diagnosis is regarded the best preventive practice. Hematuria is a specific sign of the malignancy as well as a kind of various medication-related adverse reactions. Some anti-coagulation therapy can cause bleedings including hematuria to the patients with cardiovascular diseases such as paroxysmal atrial fibrillation (PAF). Therefore, to the clinical pharmacists working in the anti-coagulation services (ACS), a closer monitoring of patients can give an opportunity to find certain ailments unexpectedly. In this case, a patient with PAF had episodes of sporadic hematuria in the course of warfarin therapy even though with its low levels of INR. An ACS pharmacist found a discrepancy between the bleeding symptoms and INR values, and recommended properly the patient to refer urologist. Fortunately, an early-stage of bladder carcinoma was found then followed by an excision performed to the lesion. Therefore, alert-minded and precise monitoring done by ACS pharmacist could optimize the therapeutic outcomes as well as increase the quality of life of the patient.

Agricultural Accidents in Farm Workers (일 지역 농업인의 농작업 재해사고)

  • Kim, Hann-Sook;Choi, Yeon-Hee
    • Research in Community and Public Health Nursing
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    • v.18 no.4
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    • pp.643-650
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    • 2007
  • Purpose: This study was to obtain information regarding to agricultural accidents in farm workers in the Kyungpook area. Methods: A questionnaire survey was carried out for 528 workers from the 1st to 31st of March, 2007. Frequency, percentage, mean and chi-square test with the SPSS program were used to analyze the data. Results: The causes of agricultural accidents include falling(29.0%), overseeing(18.9%), traffic accident(17.4%), putting between machinery(11.7%), crashing(5.3%), fire (0.6%) in the order of frequency. Injuries from agricultural accidents include fracture(44.7%) cerebral bleeding (10.4%), amputation(7.0%), airway obstruction (2.3%) burn(1.9%), drug addiction(1.9%) in the order of frequency. The largest proportion of the subjects of hospital treatment were in their 50s and belonged to the group of high-level economic state. Agricultural machinery collision was the most frequent cause among the subjects of hospital treatment. Conclusion: These results suggest that carelessness can be a potential risk factor for agricultural accidents in farm workers. These findings may give useful information for developing agricultural accident prevention programs for farm workers.

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Mastopexy Performed in a Liver Transplantation Recipient: A Case Report (간이식 수용자에서 시행한 유방 고정술의 증례보고)

  • Lee, Kang-Woo;Lee, Taik-Jong
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.527-530
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    • 2011
  • Purpose: Liver transplantation is a groundbreaking section in the field of surgery. Nowadays over 90% of success rate is accomplished and life expectancy of the patients has been elongated. Patients are now seeking for surgical procedures including cosmetic plastic surgery. But these patients take immunosuppressive medication and steroids, which can increase the risk of wound infection, and delay wound healing. By reviewing the case of a 21-year-old liver transplant recipient who underwent mastopexy due to breast ptosis, we discussed about the matters we should consider when performing surgery in liver transplantation recipients. Methods: The patient was a 21-year-old female who received liver transplantation from her father. She was exposed to massive amount of steroids and immunosuppressants, which led to breast ptosis. The vertical and short horizontal incision mastopexy using a medial-based pedicle was done, 29 months after the liver transplantation. Results: On postoperative day 1, she was discharged. On day 10, sutures were removed and taping was applied. There was no sign of wound infection, wound dehiscence, hematoma or bleeding. The patient was followed up at 3, 6 and 9 months after the operation. Mild recurrence of the glandular ptosis was observed but revision was not required. Conclusion: We were able to successfully operate without any complications in the liver transplant recipient. With special attention and consideration, cosmetic plastic surgery can be safely performed in organ transplantation recipients.

Clinical Review of Total Thyroidectomy (갑상선 전절제술의 임상분석)

  • Kno Yoon-Hoi;Kim Cheong-Hoon;Ahn Byung-Kweon;Kim Joong-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.45-50
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    • 1997
  • Total thyroidectomy has been advocated as the treatment of choice for most well differentiated thyroid carcinomas. Many surgeons have an aversion to total thyroidectomy, however, because of an allegedly high frequency of complications as compared with those resulting from other operation methods. In this report we reviewed our experience with 37 consecutive total thyroidectomy(January 1995 to December 1996). The clinical features are similar to other studies. The sex ratio is 1 : 3.1(M : F), third decade occupies 33% of cases. The anterior neck mass is the most frequent symptom(95%). In the duration of symptom, 35% of patients was within 3 months. Thirty five cases are cancer, and two cases are Hashimoto's thyroditis. The papillary carcinoma is the most common pathologic type(86%). Total thyroidectomy was done in 20 cases, and total thyroidectomy with modified neck dissection was done in 17 cases. The five postoperative complications occurred in 3 patients among 37 patients: postoperative bleeding in 1, transient hoarseness in 2, transient hypoparathyroidism in 2. Thirty four cases received $I^{131}$ scan and therapy, two cases received thyroid hormone replacement, and one case received chemotherapy. We think that total thyroidectomy can be done without additional risk compared with other thyroid operation methods, with meticulous and careful surgical technique.

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Treatment of the wide open wound in the Ehlers-Danlos syndrome

  • Baik, Bong Soo;Lee, Wu Seop;Park, Ki Sung;Yang, Wan Suk;Ji, So Young
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.130-133
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    • 2019
  • Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.

Camouflage treatment by backward rotation of the mandible for a severe skeletal Class III malocclusion with aplastic anemia: A case report

  • Choi, Dong-Soon;Lee, Dong-Hyun;Jang, Insan;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.52 no.5
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    • pp.362-371
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    • 2022
  • Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

Spontaneous Rupture of the Internal Thoracic Artery Causing a Mediastinal Hematoma in a Patient with Alcoholic Liver Cirrhosis: A Case Report (알코올성 간경화증환자에서 발견된 속가슴동맥의 자발성 파열로 인한 종격동 혈종: 증례 보고)

  • Jae Yang Park;Eun-Ju Kang;Jaehyung Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.750-756
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    • 2023
  • Spontaneous arterial bleeding is uncommon, and a mediastinal hematoma caused by spontaneous rupture of the internal thoracic artery has not been reported previously. Patients with liver cirrhosis or heavy alcohol consumption have a higher risk of hemorrhage than those without cirrhosis or excessive alcohol consumption. We present the case of a 39-year-old female with a history of alcoholic liver cirrhosis, who presented with a large mediastinal hematoma attributable to spontaneous rupture of the internal thoracic artery.

Analysis of Risk Factors in Coronary Artery Bypass Surgery (관동맥우회술의 위험인자 분석)

  • 정태은;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1049-1055
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    • 1998
  • Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

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