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1.
Yonsei Medical Journal ; : 686-689, 2013.
Article Dans Anglais | WPRIM | ID: wpr-193933

Résumé

PURPOSE: Few reports have been made on the therapeutic effects as well as pathological features of an antithrombin preparation in patients diagnosed with septic disseminated intravascular coagulation (DIC) by the diagnostic criteria for acute DIC. MATERIALS AND METHODS: A total of 88 sepsis patients who had received inpatient hospital care during the period from January 2000 through December 2008 were divided into two groups, an antithrombin group and a non-antithrombin group, to study the outcomes. Furthermore, the relationship between sepsis-related factors and DIC in 44 patients was studied. RESULTS: The antithrombin group contained 34 patients, and the non-antithrombin group contained 54 patients. The outcomes were significantly better in the antithrombin group. The levels of protein C were low in DIC patients. CONCLUSION: Our results suggest that early administration of antithrombin might improve outcomes of septic DIC patients in the diagnostic criteria for Japanese Association for Acute Medicine acute DIC.


Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Coagulation intravasculaire disséminée/complications , Fibrinolytiques/usage thérapeutique , Sepsie/complications , Facteurs temps , Résultat thérapeutique
2.
Medical Education ; : 217-224, 2011.
Article Dans Anglais | WPRIM | ID: wpr-375989

Résumé

The preparation for influenza pandemic has become very important. However, no standardized educational package against pandemics has been established to date. We developed a simulation–based education drill for Japanese medical students based on the package developed by U.S. medical school. The drill was adapted to 201 medical students, and was evaluated by self–administered questionnaires.<br>1)More than 90% of the students indicated that the use of this drill is appropriate to experience a simulated pandemic situation, and to learn skills and attitudes such as teamwork and communication.<br>2)Up to 65% of the students answered they learned a "very clear image" for the "Importance of working as a team with other professionals".<br>3)The results suggest that this simulation–based education drill make the students aware not only of the need for the preparation for pandemic but also the importance of team–based approach.

3.
Yonsei Medical Journal ; : 354-359, 2010.
Article Dans Anglais | WPRIM | ID: wpr-40409

Résumé

PURPOSE: Atrial natriuretic peptide (ANP) has a variety of pharmacologic effects, including natriuresis, diuresis, vasodilatation, and suppression of the renin-angiotensin system. A recent study showed that ANP infusion improved hypoxemia and pulmonary hypertension in a lung injury model. On the other hand, the pulse contour cardiac output (PiCCO(TM)) system (Pulsion Medical Systems, Munich, Germany) allows monitoring of the intravascular volume status and may be used to guide volume therapy in severe sepsis and critically ill patients. MATERIALS AND METHODS: We treated 10 pulmonary edema patients without heart disease with human ANP (HANP). The patients were divided into two groups: a group with normal Intrathoracic Blood Volume (ITBV) (900-1100 mL/m2) (n = 6), and a group with abnormal ITBV (n = 4), as measured by the PiCCOtrade mark device; the extravascular lung water (EVLW) and pulmonary vascular permeability index (PVPI) in the two groups were compared. RESULTS: The average patient age was 63.9 +/- 14.4 years. The normal ITBV group showed significant improvement of the EVLW (before, 16.7 +/- 2.7 mL/kg; after, 10.5 +/- 3.6 mL/kg; p = 0.0020) and PVPI (before, 3.2 +/- 0.3; after, 2.1 +/- 0.7; p = 0.0214) after the treatment. The abnormal ITBV group showed no significant improvement of either the EVLW (before, 16.3 +/- 8.9 mL/kg; after, 18.8 +/- 9.6 mL/kg; p = 0.8387) or PVPI (before, 2.3 +/- 0.8; after, 2.7 +/- 1.3; p = 0.2782) after the treatment. In both groups, the EVLW and PVPI were strongly correlated with the chest X-ray findings. CONCLUSION: We conclude that HANP supplementation may improve the EVLW and PVPI in pulmonary edema patients without heart disease with a normal ITBV. The PiCCO(TM) system seems to be a useful device for the management of pulmonary edema.


Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Facteur atrial natriurétique/administration et posologie , Débit cardiaque/effets des médicaments et des substances chimiques , Injections veineuses , Monitorage physiologique/instrumentation , Oedème pulmonaire/traitement médicamenteux
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