• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.92-95
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• 2012

장골근 파열은 매우 드물게 발생하는 손상으로 고에너지 외상이나 혈액 응고 기능 장애, 항혈액응고제 사용자, 혈우병 환자 등 출혈경향이 있는 환자에서 저에너지 손상을 받는 경우에 발생할 수 있다. 장골근의 파열로 인한 혈종의 압박에 의해 발생한 대퇴 신경 마비가 국내에도 드물게 보고된 바가 있다. 자기공명영상 검사로 병변 부위를 확진하고 신경전도 검사 및 근전도 검사로 대퇴신경 마비의 범위를 평가할 수 있고 혈액응고 기능에 문제가 있거나 출혈경향이 있는 환자를 선별하기 위해 반드시 혈액학적인 검사가 선행되어야 한다. 저자들은 정상적인 32세 남자가 축구 경기 도중 공을 차는 동작에서 발생한 장골근 파열 및 혈종의 압박으로 인한 부분적인 대퇴신경 마비의 증례를 경험하고 6개월간 추시 관찰하였으며, 양호한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제42권5호
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• pp.377-381
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• 2007

Objective : High-molecular-weight hydroxyethyl starch (HES) compromises blood coagulation more than does low-molecular-weight HES. We compared the effects of low- and high-molecular-weight HES for the treatment of vasospasm and investigated the dose relationship with each other. Methods : Retrospectively, in a series of consecutive 102 patients with subarachnoid hemorrhage (SAH), 35 patients developed clinical symptoms of vasospasm of these fourteen patients were treated with low-molecular weight HES for volume expansion while the other 21 received high-molecular-weight HES as continuous intravenous infusion. Prothrombin time (PT), partial thromboplastin time (PIT), fibrinogen level, and platelet count were all measured prior to initiation, during treatment and after termination of therapy for symptomatic vasospasm. The total dose of HES ranged from 5 L to 14 L and median infusion duration was 10 days. Results : A more pronounced PTT prolongation was observed in high-molecular-weight HES group compared with low-molecular-weight HES group. No other coagulation parameters were altered. Dosage (=duration) shows a positive correlation with PTT. Clinically, significant bleeding episodes were noted in four patients who received high-molecular-weight HES. Conclusion : Coagulopathy was developed in direct proportion to molecular weight of starch and dosages. We propose the extreme caution in the administration of HES solution for the vasospasm treatment.

• 대한유전성대사질환학회지
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• 제12권1호
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• pp.35-41
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• 2012

본 연구는 심한 발현 양상을 보인 NICCD 환자의 임상상과 그들의 분자 유전학적 결과를 고찰하여, NICCD의 빠른 진단 및 치료를 통해 임상 경과의 호전을 관찰하였기에 이를 보고하는 바이다. 신생아 광범위 대사 이상 질환 스크리닝 검사의 보편화와 더불어 NICCD 환자들의 진단 수는 앞으로 지속적으로 증가할 것으로 보이며, 이들의 장기적인 경과 관찰을 통한 예후 인자 및 새로운 치료적 접근법을 도출해내야 할 것이다.

• 한국동물위생학회지
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• 제34권2호
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• pp.191-193
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• 2011

A 3-month-old intact male, Labrador retriever was presented with the history of coagulopathy and anemia. The results of initial screening tests of the hemostatic system yielded a tentative diagnosis of hemophilia. Activated partial thromboplastin time (APTT) was distinctly prolonged (106 seconds) and prothrombin time (PT) was not detected due to markedly prolonged test time. Whole blood transfusions (20 me l/kg body weight) were carried out prior to assays of coagulation factor. After transfusion, the patient recovered well and hemorrhage ceased. Blood samples were assessed for coagulation factor activity. The patient showed markedly low factor IX coagulation activity (5%, reference range: 7~140%) and was diagnosed with hemophilia B. After recovery, the patient was discharged from the hospital. However, 4 months later the patient was re-hospitalized for recurrence of the initial symptoms. The owner did not want to pursue further treatment and the patient died of respiratory distress two days later.

• 한국동물위생학회지
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• 제45권1호
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• pp.55-61
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• 2022

In veterinary medicine, a variety of disease are known to cause coagulation abnormalities. Identification of these coagulation abnormalities have been relied on traditional coagulation assays(platelet concentration, aPTT, PT, D-dimer, fibrinogen) which take only a small part of the coagulation pathways rather than global hemostatic capacity. Among of the hypercoagulable diseases, cardiovascular disease, such as mitral valvular disease, was not regarded as the cause of the hypercoagulability. The value of a thromboelastography (TEG) as an early predictor of coagulopathy, especially hypercoagulability, has been founded. It was associated with decreased R and K values, and increased MA and α angle. The objective of this study was to compare thromboelastography results and those of traditional coagulation tests between twenty adult dogs with mitral insufficiency (MVI group) and eleven adult healthy dogs (Healthy group). As a results, MA values in the patients with mitral insufficiency (68.8±7.8 mm) were significantly higher than the normal patients (60.4±4.8 mm) (P value<0.05). Although a little report has been reported in veterinary medicine, platelet activation seems to be related with hypercoagulability in MVI patients in human medicine. The result of this report can support this pathophysiology in veterinary medicine. In addition to traditional coagulation assay, global assessment of coagulopathy using TEG, especially ability to detect hypercoagulability, may be useful for customized treatment in MVI patients. To achieve this, further study is needed to define pathophysiology and effect of medication.

• 대한수의학회지
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• 제48권4호
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• pp.493-500
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• 2008

A 2-year-old female Pekingese dog was presented with primary complaints including exercise intolerance and neurological sign associated with hepatic encephalopathy. The major findings in clinical examination included an intermittent seizure, a slow heart rate with pulse deficit, leukocytosis and anemia in hemogram, elevated pre- and post-prandial serum bile acid and hepatic enzymes, hypoproteinemia, coagulopathy, ammonium urate crystaluria and bilirubinuria. Diagnostic tests revealed an intrahepatic portosystemic shunt complicated with a second degree atrioventricular block and QT prolongation. The case was successfully treated with a transvenous coil embolization. Clinical signs were gradually improved and cardiac bradyarrhythmia disappeared. This case is a rare case of intrahepatic portosystemic shunts complicated with a cardiac bradyarrhythmia in a small breed dog fixed by a transvenous coil embolization.

• Journal of Korean Neurosurgical Society
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• 제53권2호
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• pp.108-111
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• 2013

Burr hole drainage has been widely used to treat chronic subdural hematomas (SDH), and most of them are easily treated by simple trephination and drainage. However, various complications, such as, hematoma recurrence, infection, seizure, cerebral edema, tension pneumocephalus and failure of the brain to expand due to cerebro-cranial disproportion may develop after chronic SDH drainage. Among them, intracerebral hemorrhage after evacuation of a recurrent chronic SDH is very rare. Here, we report a fatal case of delayed intracerebral hemorrhage caused by coagulopathy following evacuation of a chronic SDH. Possible pathogenic mechanisms of this unfavorable complication are discussed and a review of pertinent literature is included.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.371-375
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• 2015

Spontaneous spinal subdural hematoma is reported at a rare level of incidence, and is frequently associated with underlying coagulopathy or those receiving anticoagulant or antiplatelet agents; some cases accompany concomitant intracranial hemorrhage. The spontaneous development of spinal subdural hemorrhage (SDH) is a neurological emergency; therefore, early diagnosis, the discontinuation of anticoagulant, and urgent surgical decompression are required to enable neurological recovery. In this report, we present a simultaneous spinal subdural hematoma and cranial subarachnoid hemorrhage, which mimicked an aneurysmal origin in a female patient who had been taking warfarin due to aortic valve replacement surgery.

• Journal of Trauma and Injury
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• 제33권2호
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• pp.112-118
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• 2020

In trauma patients, coagulopathy and abnormal increases or decreases in cell counts are frequently observed, and are associated with high mortality and morbidity in the acute phase of trauma. Because major trauma is often life-threatening, and hematologic abnormalities are multi-factorial and transient, major blood loss is usually suspected to be the primary cause of these abnormalities, and much time and cost may be spent attempting to identify a focus of hemorrhage that might or might not actually exist. Persistent abnormalities in the complete blood count, however, require clinical suspicion of other hematologic diseases to minimize improper transfusions and to improve outcomes, including mortality. Physicians at trauma centers should be familiar with the clinical characteristics of hematologic diseases and should consider these diseases in trauma patients. In this report, we present cases of two hematologic disorders found in trauma patients: autoimmune hemolytic anemia induced by systemic lupus erythematosus and myelodysplastic syndrome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.210-213
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• 2008

저자들은 버섯 중독 후 간성 뇌증을 동반한 급성 간부전으로 발현된 소아를 Penicillin GK를 사용한 약물 요법으로 완치할 수 있었다. 소아에서 급성 간부전은 사망률이 높은 위중한 질병이며, 생존을 위하여 간이식이 필요한 경우가 많다. 그러나 일부의 경우에는 본 증례와 같이 정확한 병력 청취에 의하여 특별한 치료를 시행하면 간이식을 시행하지 않고서도 환아의 생명을 구할 수 있다.