• Title/Summary/Keyword: 혈액 응고인자

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Spontaneous Echo Contrast Observed on Carotid Duplex Ultrasonography (경동맥이중초음파검사에서 관찰된 자발에코대조)

  • Minho HAN
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.273-276
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    • 2024
  • Spontaneous echo contrast is a swirling, smoke-like echographic pattern observed in B-mode ultrasound imaging, typically arising in areas of blood stasis or low-flow states. This hemodynamic disturbance generates low shear stress due to sluggish flow, leading to endothelial dysfunction and facilitating the activation of fibrinogen, a coagulation factor. Consequently, blood cells, including erythrocytes, readily aggregate, forming a spontaneous echo contrast, a precursor to thrombus formation. Spontaneous echo contrast is primarily found in the left atrium of patients with left atrial enlargement or the left atrial appendage of patients with atrial fibrillation. While less common, it can also be observed in the carotid arteries. This case report presents the imaging findings of spontaneous echo contrast detected during carotid duplex ultrasonography in a patient with metastatic cancer and discusses its clinical implications.

국소적 소인에 의한 구강내 출혈

  • Park, Gwang-Ho
    • The Journal of the Korean dental association
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    • v.27 no.7 s.242
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    • pp.609-610
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    • 1989
  • 국소적 소인에 의한 구강내 출혈은 구소적 감염이나 원인 혹은 외상등에 의해 야기되는 것으로 혈액응고에 관여하는 여러인자의 양적, 질적 이상으로 유발되는 출혈성 소인에 의한 출혈과는 구별되어 진다. 대부분의 치과의사가 접할 수 있는 가장 흔한 출혈은 국소적 소인에 의한 것이며, 명심해야 될 사항은 이런 국소적 소인에 전신적 출혈성 소인의 한 요소일 수도 있다는 점이다. 이에 치과의사들은 구강내에서 국소적 원인을 쉽게 발견 치료할 수도 있으나, 전신적 출혈성 소인에 대한 연관성 조사를 항시 염두에 두어야 하겠다. 출혈성 소인에 의한 출혈은 특별한 외상 없이도 되부, 점막, 관절등에 자연히 출혈이 일어나며, 가벼운 외상에 의해서도 쉽게 출혈하는 경향이 있는 점이 국소적 소인에 의한 출혈과의 감별사항이다. 가장 관찰하기 쉬운 곳이 피부 및 점막으로 출혈하여 피가 모인 것을 자반(Purpura)이라 하며, 크기 및 정도에 따라 모세혈관에서의 출혈은 점상출혈(Petechia), 세동맥 및 세정맥에서의 출혈은 반상출혈(Ecchymosis), 좀더 심부에서 출혈하여 촉지되는 혈종(Hematoma)으로 나눌 수 있다. 임상적으로 구별되는 이런 양상을 잘 관찰하고 주의해야 하겠다.

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Effects of the Dosing Regimen of Tissue-type Plasminogen Activator on Blood Coagulation System in Experimental Pulmonary Embolism (실험적 폐색전증에서 조직형플라스미노겐활성체의 투여방법이 혈액응고기전에 미치는 영향)

  • Chung, Hee-Soon;Kim, Ho-Joong;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.474-482
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    • 1993
  • Background: As a physiologic plasminogen activator, tissue-type plasminogen activator (t-PA) could induce effective thrombolysis in massive pulmonary embolism, without the risk of systemic hemorrhage. However, therapeutic doses of t-PA has been associated with systemic lytic state, and fibrin selectivity may be influenced by the dosing regimen of t-PA. To investigate the effects of duration of t-PA infusion on blood coagulation system, we performed this study. Method: In a canine model of pulmonary embolism, which was induced by injection of autologous blood clots, we administered equal doses of t-PA (1 mg/kg) over 15 minutes in $t-PA_{15}$ group, over 180 minutes in $t-PA_{180}$ group, and only saline in control group. Then serial blood samplings were made to check complete blood count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrin, plasminogen, ${\alpha}_2$-antiplasmin, coagulation factor V and VIII, and fibrin(ogen) degradation products. Results: 1) In all 3 groups, complete blood count showed same changes. Hemoglobin, hematocrit and platelet count decreased, but WBC count increased. 2) Prothrombin time, activated partial thromboplastin time, and thrombin time were prolonged during 15-60 minutes after t-PA administration in $t-PA_{15}$ group, and from 30 minutes through 180 minutes after administration in $t-PA_{180}$ gorup. 3) Fibrin, ${\alpha}_2$-antiplasmin, and cogulation factor V and VIII decreased in both $t-PA_{15}$ and $t-PA_{180}$ group, but returned to basal levels earlier in $t-PA_{15}$ group. 4) Fibrin(ogen) degradation products increased after pulmonary embolism in all groups, and further increased in both $t-PA_{15}$ and $t-PA_{180}$ groups after t-PA infusion. But more pronounced increment was noted in $t-PA_{180}$ gorup. Conclusion: In pulmonary embolism, the shorter (15 minutes) infusion of t-PA would have less risk of systemic hemorrhage than the longer (180 minutes) infusion when the doses is equal. And, this suggests that manipulating the duration of t-PA infusion can reduce the risk of major bleeding.

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Depression and Coronary Artery Disease(I) : Pathophysiologic Mechanisms (우울증과 관상동맥 질환(I) : 병태생리적 기전)

  • Bae, Kyung-Yeol;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.275-287
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    • 2008
  • Depression and coronary artery disease are both highly prevalent diseases. Many previous studies suggest that depression is a common comorbid condition in patients with coronary artery disease and has a significant negative impact on the onset, course, and prognosis of coronary artery disease. However, the exact mechanisms that underlie the association between these two diseases remain unclear. Pathophysiologic mechanisms that may explain the effect of depression on coronary artery disease include hypercoagulability, hypothalamus-pituitary-adrenal axis and autonomic nervous system dysregulation, altered inflammatory response. On the contrary, pathophysiologic mechanisms in coronary artery disease that affect depression are less well known. It is also suggested that both diseases may share a common genetic vulnerability. The authors reviewed the literature on the pathophysiologic relationships of depression and coronary heart disease.

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Comparative Inactivation of Hepatitis A Virus and Murine Encephalomyocarditis Virus to Various Inactivation Processes (바이러스 불활화 공정에 대한 Hepatitis A Virus와 Murine Encephalomyocarditis Virus의 민감도 비교)

  • Kim, In-Seop
    • Korean Journal of Microbiology
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    • v.39 no.4
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    • pp.242-247
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    • 2003
  • Murine encephalomyocarditis virus (EMCV) has been used as a surrogate for hepatitis A virus (HAV) for the validation of virus removal and/or inactivation during the manufacturing process of biopharmaceuticals. Recently international regulation for the validation of HAV safety has been reinforced because of the reported cases of HAV transmission to hemophiliac patients who had received ntihemophilic factors prepared from human plasma. The purpose of the present study was to compare the resistance of HAV and EMCV to various viral inactivation processes and then to standardize the HAV validation method. HAV was more resistant than EMCV to pasteurization (60oC heat treatment for 10 hr), low pH incubation (pH 3.9 at 25oC for 14 days), 0.1 M NaOH treatment, and lyophilization. EMCV was completely inactivated to undetectable levels within 2 hr of pasteurization, however, HAV was completely inactivated to undetectable levels after 5 hr treatment. EMCV was completely inactivated to undetectable levels within 15 min of 0.1 M NaOH treatment, however, residual infectivity of HAV still remained even after 120 min of treatment. The log reduction factors achieved during low pH incubation were 1.63 for HAV and 3.84 for EMCV. Also the log reduction factors achieved during a lyophilization process of antihemophilic factor VIII were 1.21 for HAV and 4.57 for EMCV. These results indicate that HAV rather than EMCV should be used for the virus validation study and the validation results obtained using EMCV should be precisely reviewed.

Stomach Cancer Secondary to Hematologic Diseases (혈액질환에 속발하는 이차성 위암)

  • Kim, Ji-Hoon;Jee, Sung-Bae;Huh, Hoon;Chin, Hyung-Min;Kim, Wook;Kim, Dong-Wook;Lee, Jong-Wook;Min, Woo-Sung;Kim, Choon-Choo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.237-241
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    • 2007
  • Purpose: Patients with hematologic diseases such as chronic myeloid leukemia (CML) or chronic lymphoid leukemia (CLL) are known to have an increased chance of acquiring a secondary neoplasm. Stomach cancer is one of the most common malignant diseases in Korea, and we investigated whether the incidence of secondary stomach cancer in patients with a hematologic disease increases, in order to determine if a more intensive screening program for detecting secondary gastric cancer was required. We also investigated the safety of performing a gastrectomy in hematologic disease patients. Materials and Methods: From 1992 to 2006, the medical records of 8376 patients diagnosed with one of the six common hematologic diseases were reviewed. Results: Nine secondary stomach cancers were found among the 8376 patients during the 15-year observation period. No surgical-related complications occurred, and there was no recurrence of stomach cancer if detected early. Conclusion: It seems that a more intensive screening program for detecting secondary gastric cancer in hematologic disease patients is not required, and surgery is not risky in these patients.

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A Case of Massive Pulmonary Thromboembolism in a Young Man Attribute to Computer Gaming (젊은 남자에서 장시간의 컴퓨터게임 후 발생한 대량 폐색전증 1예)

  • Kim, Hyun;Choe, Kang Hyeon;Lee, Ki Man;Shin, Yoon Mi
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.211-215
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    • 2009
  • Pulmonary thromboembolism occurs in old patients with risk factors, such as, immobilization, chronic medical disease, trauma, a hereditary hypercoagulable state, and others. However, we experienced a young man with a massive pulmonary thromboembolism attributed to immobilization due to computer gaming. The patient had been playing computer games in a seated position for at least five hour continually, and for twelve hours per day over a two-week period. The 36-year-old patient was transferred to our institute rule out the possibility of an acute myocardial infarction. Computer tomography revealed intraluminal filling defects in the distal main pulmonary artery and the left popliteal vein. He received thrombolytic therapy and subsequently recovered without complications. This case raises the possibility that prolonged computer gaming is a risk factor of thromboembolism in young adults.

Evaluation of in-vitro Antithrombosis Activity of Lees of Korean Traditional Wine (전통주 주박의 항혈전 활성 평가)

  • Kim, Mi-Sun;Lee, Ye-Seul;Kim, Jong Sik;Shin, Woo-Chang;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.24 no.8
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    • pp.865-872
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    • 2014
  • In this study, ethanol and hot water extracts of lees from Korean traditional wine (J-B, J-S, J-Y, J-H, and J-W) were prepared, and their effects on blood coagulation, platelet aggregation, and hemolysis of human red blood cells (hRBCs) were investigated to develop functional food ingredients from lees. The pH and brix of the lees ranged from 3.90 to 4.29 and 5.0 to $27.0^{\circ}$, respectively, and there was a huge difference in the water and ethanol content among the lees. The nuruk and additives used affected the color and physicochemical properties of lees. The J-W takju made from only rice and traditional nuruk, which has $13^{\circ}$ brix and 1.8% of alcohol, has potential as functional food ingredient. With regard to the extraction yields of lees, higher yields were obtained from J-H, which contains different medicinal plants, in ethanol, followed by J-W, J-B, J-S, and J-Y. Higher extraction yields of lees were obtained from J-S in hot water, followed by J-B, J-W, J-H, and J-Y, respectively. The ethanol extract of J-H and the hot water extract of J-Y had the highest contents of total polyphenol and total flavonoids among the lees extracts. The 10 lees extracts did not show hemolysis activity against hRBCs up to 5 mg/ml. In an anticoagulation activity assay, the ethanol extracts of three yakju lees (J-B, J-S, and J-Y) and the hot water extract of J-W inhibited thrombin activity, whereas the hot water extract of J-B, J-S, and J-H inhibited blood coagulation factors. In an antiplatelet aggregation activity assay, only the J-W takju lees showed significant inhibition activity. Our results suggest that lees from traditional wine had high potential as a novel antithrombosis agent.

Arterial Thoracic Outlet Syndrome due to Angiosarcoma of the Subclavian Artery a case report (동맥 흉곽 출구 증후군을 일으킨 쇄골하동맥 맥관 육종 -1례 보고-)

  • 이철범;함시영
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1160-1165
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    • 1996
  • We report a case of an angiosarcoma arising from the subclavian artery, a site not previously described. A 19-year-old girl, born with a rudimentary first rib, has been suffered from arterial thoracic outlet syndrome due to a complete occlusion of the third portion of the subclavian artery for 1 year. Partial claviculectomy, excision of completely occluded arterial segment, and reconstruction with great r saphenous vein graft were done. Histologic study for the subclavlan artery revealed mural type anglosarcoma. The histochemici1 staining for factor VIII related antigen was positive. The debilitating symptoms that did not allow her a normal daily life, almost subsided postoperatively. And she has remained well with no clinical evidence of disease for 4 months post-operation.

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A Case of Reye Syndrome Following Treatment of Kawasaki Disease with Aspirin (가와사키병 치료를 위한 아스피린 사용 후 발생한 라이 증후군 1예)

  • Lee, Joon Kee;Kang, Ji Eun;Choi, Eun Hwa;Choi, Jung Yun
    • Pediatric Infection and Vaccine
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    • v.19 no.2
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    • pp.79-83
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    • 2012
  • Reye syndrome is a rapidly progressive encephalopathy with hepatic dysfunction, which often begins several days after apparent recovery from a viral illness, especially varicella or influenza A or B. Salicylate use was identified as a major precipitating factor for the development of Reye syndrome. With the recommendation to avoid use of salicylates in children, Reye syndrome has virtually disappeared in recent years. We report a case of Reye syndrome in a 5-month-old infant who had been treated with intravenous immunoglobulin and aspirin under the diagnosis of Kawasaki disease, and showed symptoms of sudden onset of irritability, rigidity, decreased activity, vomiting, poor appetite, lethargy, liver dysfunction without jaundice, coagulopathy, and hyperammonemia.

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