ABSTRACT
PURPOSE: This study explored and evaluated the systemic complications resulting from the bite of Korean venomous snake, focussing on hematologic and neurologic features. METHODS: Medical records (demographic data, clinical measurements including laboratory results, severity score, and amount of antidote administration, and hospitalization course) of consecutive patients who presented with snakebites to two university teaching hospital during a 10-year period were retrospectively reviewed. Subgroup analysis was conducted for evaluations of anti-acetylcholine esterase administration in complicated victims. RESULTS: The 170 patients displayed occurrence rates of hematologic and neurologic complications of 12.9% and 20.6%, respectively. Among 22 patients with hematologic complications, isolated thrombocytopenia was evident in eight patients (36.4%), prothrombin time (PT)/activated partial thromboplastin time (aPTT) prolongation in 11 patients (50.0%), and both in three patients (13.6%). The mean time to recovery was 4.5+/-1.8 days for isolated thrombocytopenia, and 5.1+/-1.8 days for PT and aPTT prolongation. Hematologic complications could occur suddenly 1~4 days after hospitalization. Among 35 patients with neurologic complications, dizziness was evident in 16 patients (45.7%), and diplopia / blurred vision in 19 patients (54.3%). The mean time to recovery was 3.4+/-0.6 days in patients receiving anti-acetylcholine esterase and 6.9+/-1.8 days in those not receiving anti-acetylcholine esterase (p=0.00). CONCLUSION: Occurrence rates of hematologic and neurologic complications following venomous snake bite differed as compared to other studies conducted in Korea. Onset of hematologic complications can occur rapidly days after admittance. Anti-acetylcholine esterase administration may be effective in treating neurologic complications.
Subject(s)
Humans , Bites and Stings , Diplopia , Dizziness , Hospitalization , Hospitals, Teaching , Korea , Medical Records , Partial Thromboplastin Time , Prothrombin Time , Retrospective Studies , Snake Bites , Snakes , Thrombocytopenia , Venoms , Vision, OcularABSTRACT
BACKGROUND/AIMS: The retrocaval dissection, with venous collaterals, is sometimes difficult, making subsequent hemostasis less easy during orthotopic liver transplantation(OLT). We have recently applied a modified technique of vena caval preservation during OLT, and undertook this study to evaluate retrospectively its effects. METHODS: Five patients with liver cirrhosis underwent a modified OLT from March 1999 through July 2001. The procedure includes a side to side anastomosis between the IVC of the donor and the recipient without vena cava occlusion during OLT. RESULTS: This technique pemitted the avoidance of vena caval occlusion in all cases. We could performed OLT without venovenous bypass in 3 patients who tolerated the temporary portal clamping test before the recipient hepatectomy. As retrocaval dissection was not performed, hemostasis was esier during anhepatic phase. We could reduce anhepatic phase into average 60 minutes from only one caval anastomosis during OLT. CONCLUSIONS: We think this alternative technique, requiring only one caval anastomosis, can reduce the duration of the anhepatic phase and the need for venous bypass.