Surgical treatment of pulmonary embolism after cesarean section / 대한산부인과학회지

Pulmonary embolism (PE) is the leading cause of maternal deaths and the incidence has been increased in recent years in Asian countries. Although the treatment options available for patients with massive PE include thrombolytic therapy, catheter-directed thrombectomy, and surgical embolectomy, there are no conclusive data or evidence on the appropriate treatment of PE. We experienced a case of massive PE with large thrombus involving major pulmonary arteries immediately after emergency cesarean section and successfully treated by thrombectomy, so hereby report the case.

Surgical treatment of pulmonary embolism after cesarean section / 대한산부인과학회지

Pulmonary embolism (PE) is the leading cause of maternal deaths and the incidence has been increased in recent years in Asian countries. Although the treatment options available for patients with massive PE include thrombolytic therapy, catheter-directed thrombectomy, and surgical embolectomy, there are no conclusive data or evidence on the appropriate treatment of PE. We experienced a case of massive PE with large thrombus involving major pulmonary arteries immediately after emergency cesarean section and successfully treated by thrombectomy, so hereby report the case.

Relationship between Low Back Pain and Physical Characteristics in Flight Attendants

BACKGROUND: Low back pain (LBP) is known to be the significant reason for absenteeism and can develop long-term disability. So the airline authorities have made an effort to reduce the incidence of LBP by applying their physical standards. As a LBP Prevention Program, Airline A has provided health education, counseling and physical examinations. The purpose of this study is to analyze the relationship between LBP and physical characteristics, age and work duration, and this result will provide basic information for improving the LBP Prevention Program. METHOD: The subjects were the 585 flight attendants who had undergone regular physical check-ups with Airline A Medical Center from October 2000 to September 2001. We reviewed their absence records and physical characteristics, age and work duration. These data were analyzed statistically by the t-test and Lositic regression. RESULT: The LBP history group accounted for 18% of the study group. The male LBP history group had the more thin waist than the no history group. There were no differences (P<0.05) between LBP and other male and female physical characteristics. The age and work duration of male LBP history group was lower than the no history group (P<0.05). But the female comparison revealed that only the work experience in the LBP history group was lower than the No history group (P<0.05). Waist, age, work duration was analyzed statistically by logistic regression. Only female's work experience was significant. The fewer work experience was the more LBP. CONCLUSION: The results of this study suggest LBP is associated with work experience rather than physical characteristics. This is the first step toward improving a LBP Prevention Program for the cabin crew. It will be useful to conduct another review to assess various other reasons, such as psychosocial job factors, duration of work disability and muscle strength, related to LBP.

The Effect of Long Distance Air-travel on Serum Viscosity and Prothrombin Time

BACKGROUND: Economy class syndrome is medically described as deep vein thrombosis, it is worldwide issued that Long-Distance Air-Travel is a risk factor for venous thromboemborism. Some study provides evidence and theoretical explanations for the hypothesis that long-distance is a risk factor for venous thromboembolism. The purpose of this study is to provide the useful prevention of venous thromboembolism for long-distance travelers in comparison to the effect of long distance air-travel on serum viscosity and prothrombin time between flight level and ground level. METHODS: Subjects selected healthy volunteers that had no abnormal findings in evaluation (alpha2-plasmin inhibitor, plasminogen, anti-thrombin III, protein C, protein S) for hypercoagulability. 5subjects (1 male, 4 females) had a seat on economy class of ground training facility designed for flight attendant and their activities limited as possible during about 8 hours at Sep. 16, 2001. Also, 5 subjects had a seat on the economy class of Asiana Airlines (B-777) from Sydney in Australia to Seoul in Korea at Mar. 3, 2002. In the flight, Actual flight altitude was 31,000 feet, cabin altitude was 4,800 feet and cabin temperature was 25degrees C. We have investigated the serum viscosity used by viscometer and prothrombin time. These data were analyzed statistically by General linear model (spsswin ver. 10.0). RESULTS: The results showed that there were no differcence between Flight Group and Ground Group statistically. However, the serum viscosity of flight group by position was some higher than ground group but these defference was not statistically significance (P=0.419). Also, the serum viscosity of flight group by time had a decreased trend but these trend was not statistically significance (P=0.061). The prothrombin time of flight group by position was some lower than ground group but these defference was not statistically significance (P=0.472). Also, the prothrombin time of ground group by time had a decreased trend but these trend was not statistically significance (P=0.217). CONCLUSION: This study shows the prediction to venous thrombosis more closely relates to prothrombin time than serum viscosity under immobilization to healthy people on the ground environment. Exercise is more useful method than hydration to prevent venous thrombosis on the ground environment. In the flight environment, we think that hydration is also useful method to prevent venous thrombosis because of more dry environment inside flying aircraft. But, this study was decreased serum viscosity between samples according to time. I think serum viscosity can be reduced by vibration effect inside flying aircraft. Serum viscosity and prothrombin time between samples according to position were not statistically significant. I think that risk for the healthy people is poorly quantified and possibly overestimated that long-distance air-travel is a risk factor for venous thromboembolism.