• Title/Summary/Keyword: Coagulation therapy

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Efficacy and General Pharmacology of Recombinant Human Erythropoietin(DA-3285) (Recombinant Human Erythropoietin(DA-3285)의 효력 및 일반약리작용)

  • 김동환;안병옥;손문호;신명수;이성희;김원배;양중익
    • Biomolecules & Therapeutics
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    • v.4 no.1
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    • pp.68-77
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    • 1996
  • Efficacy and general pharmacology of recombinant human erythropoietin (rHu-EPO), were investigated. Efficacy studies were conducted in normal, cisplatin- and acute hemorrhage-induced anemic rats. Normal and anemic animals were treated intravenously with rHu-EPO for 5 days and the changes in the numbers of red blood cells (RBC), hemoglobin (Hb), hematocrit (Hct) and reticulocytes (Ret) were examined. In normal rats, rHu-EPO significantly increased RBC, Hb, Hct and Ret at doses of 50∼ 1250 IU/kg/day. Cisplatin-induced anemic rats showed significant increase of RBC, Hb, Hct and Ret in a dose-dependent manner after administration of rHu-EPO (50∼200 lU/kg/day). And in acute hemorrhage-induced anemic rats, rHu-EPO(4∼100 Iu/kg/day) accelerated recovery of anemia with significant increase in Ret. These changes disappeared gradually after cessation of the treatment. The general pharmacological effects of rHu-EPO were investigated in mice, rats, guinea-pigs, rabbits and cats. rHu-EPO had no influences on central nervous, cardiovascular, gastrointestinal and blood coagulation system. It also had no influence on the contraction of phrenic nerve-diaphragm preparation. rHu-EPO produced significant increase of urine volume at a dose of 7000 IU/kg. These results suggest that rHu-EPO might be useful for the therapy of anemia without serious side effect.

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A Case of Dural Arteriovenous Fistula of Superior Sagittal Sinus after Tamoxifen Treatment for Breast Cancer

  • Hwang, Sung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.204-207
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    • 2015
  • We are reporting an unusual case of dural arteriovenous fistula (AVF) of the superior sagittal sinus (SSS) after tamoxifen treatment for breast cancer. A 30-year-old female arrived at the emergency room with a sudden headache and left sided weakness and sensory loss. In her past medical history, she was diagnosed with breast cancer 1 year prior, and subsequently underwent a breast conserving mastectomy with whole breast radiation and adjuvant chemotherapy with tamoxifen. At the time of admission, computed tomography showed a small acute intracerebral hemorrhage at the right parietal cortex, and magnetic resonance imaging showed that a dural AVF at the SSS with a prominent and tortuous venous enhancement along the centrum semiovale was present. Cerebral angiography showed that the dural AVF at the mid-portion of the SSS with meningeal arterial feeding vessels entering the wall of the SSS, then draining through the dilated cortical veins. Our patient had no signs of active malignancy or any abnormalities in her coagulation profile, so it can be concluded that the tamoxifen was the likely cause of the SSS thrombosis and dural AVF. The dural AVF was treated by an endovascular coil embolization for the arterialized segment of the SSS. The patient dramatically recovered favorably from left side motor and sensory deficit. The best clinical approach is to screen potential patients of tamoxifen hormonal therapy and educate them on the sign and symptoms of life threatening thromboembolic events while taking tamoxifen.

A Pilot Study of Skin Resurfacing Using the 2,790-nm Erbium:YSGG Laser System

  • Rhie, Jong Won;Shim, Jeong Su;Choi, Won Seok
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.52-58
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    • 2015
  • Background The erbium:yttrium scandium gallium garnet (Er:YSGG) laser differs from other laser techniques by having a faster and higher cure rate. Since the Er:YSGG laser causes an appropriate proportion of ablation and coagulation, it has advantages over the conventional carbon dioxide ($CO_2$) laser and the erbium-doped yttrium aluminum garnet (Er:YAG) laser, including heating tendencies and explosive vaporization. This research was conducted to explore the effects and safety of the Er:YSGG laser. Methods Twenty patients participated in the pilot study of a resurfacing system using a 2,790-nm Er:YSGG laser. All patients received facial treatment by the 2,790-nm Er:YSGG laser system (Cutera) twice with a 4-week interval. Wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture were measured. Results Study subjects included 15 women and five men. Re-epithelization occurred in all subjects 3 to 4 days after treatment, and wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture within 6 months of treatment. Conclusions The 2,790-nm YSGG laser technique had fewer complications and was effective in the improvement of scars, pores, wrinkles, and skin tone and color with one or two treatments. We expect this method to be effective for people with acne scars, pore scars, deep wrinkles, and uneven skin texture and color.

The Changes of Blood Biochemical Values during Warfarin Therapy in Calves (송아지에 warfarin 투여 시에 혈액 생화학치의 변화)

  • 임건태;윤영민;이경갑
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.74-78
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    • 2003
  • We executed this experiment to observe side effects of warfarin, the anticoagulant that is used for preventing thrombus in cardiovascular surgery for calves. The 6 calves(70-130 kg) were used in this experiment regardless of sexes. We administered warfarin at 0.07 mg/kg daily for 25 days. Blood was collected before warfarin administration, every five days for 30 days. PCV, RBC, WBC, fibrinogen, total protein and platelet as blood test, prothrombin time (PT) as blood coagulation test, and AST, SDH, total bilirubin, BUN and creatinine as serum biochemical tests were measured. As the result of the experiment, PT has been gradually increased after warfarin administration. It has been gradually increased and remains within the therapeutic range from the third day to the 28th day. PCV and RBC were decreased significantly from the value before the administration (p < 0.05). In the serum biochemical test, SDH shows significant increase comparing the value before the administration (p < 0.05). AST and total bilirubin were increased gradually from the value before the administration. Considering the result of the experiment, to give wafarin to prevent thrombus in cardiovascular surgery, we can get anticoagulation effect with minimal administration(0.07 mg/kg, PO) from the third day of the administration. However because of the decreased PCV and RBC, it may cause anemia. It may cause damage to liver based on the result of serum biochemical test.

Radiosynovectomy (방사성 활막절제술)

  • Kim, Deog-Yoon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.127-131
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    • 2006
  • Radiosynovectomy has been used as an effective treatment in patients with resistant synovitis after failure of long-term medication and intraarticular steroid injection. Although $^{90}Y$ silicate/citrate, $^{186}Re$ sulfide, and $^{169}Er$ citrate were approved in Europe for the appropriate radiopharmaceuticals for radiosynovectomy other radionuclides such as $^{32}P$-chromic phosphate, $^{165}Dy$-ferric hydroxide macroaggregate, $^{188}Rh$-microspheres, $^{153}Sm-particulate, and $^{166}Ho$-ferric hydroxide macroaggregate have been used in many countries. Reported success rates range from 40% to 90% for the different joints and underlying disease. In Korea, $^{188}Re$-tin-colloid and $^{166}Ho$-chitosan complex are now using as the major radionuclides in radiosynovectomy with good clinical results. A study on radiation synovectomy using $^{188}Re$-tin-colloid for patients with Korean rheumatoid arthritis shows the treatment resulted in the improvement of arthritis and well tolerated in our study, the radiosynovectomy with $^{166}Ho$-chitosan complex in 53 hemophilic patients markedly decreased intra-articular bleeding frequency and need for coagulation factor. This review inculdes general priciples in the application of radiosynovectomy and the clinical experience in Korea.

Epistaxis in dental and maxillofacial practice: a comprehensive review

  • Psillas, George;Dimas, Grigorios Georgios;Papaioannou, Despoina;Savopoulos, Christos;Constantinidis, Jiannis
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.13-20
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    • 2022
  • The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

Treatment of Refractory Melasma with Microwave-generated, Atmospheric-pressure, Non-thermal Nitrogen Plasma

  • Kim, Hyun-Jo;Kim, Heesu;Kim, Young Koo;Cho, Sung Bin
    • Medical Lasers
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    • v.8 no.2
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    • pp.74-79
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    • 2019
  • Periorbital melasma is often refractory to treatment and highly associated with rebound hyperpigmentation or mottled hypopigmentation after laser treatment in Asian patients. In this report, we describe 2 patients with cluster-1 periorbital melasma and 1 patient with cluster-2 periorbital melasma who experienced remarkable clinical improvements after microwave-generated, atmospheric-pressure, non-thermal nitrogen plasma treatments. All patients exhibited limited clinical responses after combination treatments with topical bleaching agents, systemic oral tranexamic acid, and low-fluenced Q-switched neodymium (Nd):yttrium-aluminum-garnet (YAG) lasers. Low-energy nitrogen plasma treatment at 0.75 J elicited remarkable clinical improvement in the periorbital melasma lesions without post-laser therapy rebound hyperpigmentation and mottled hypopigmentation. We deemed that a single pass of nitrogen plasma treatment at 0.75 J induces mild microscopic thermal tissue coagulation and modification within the epidermis while preserving the integrity of the basement membrane in patients with periorbital melasma. Accordingly, nitrogen plasma-induced dermal tissue regeneration could play a role in the treatment of melasma lesions.

Lupus anticoagulant hypoprothrombinemia syndrome associated with a hemorrhagic ovarian cyst in a girl with systemic lupus erythematosus: a case report

  • Min Hwa Son;Hyung Eun Yim
    • Childhood Kidney Diseases
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    • v.28 no.2
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    • pp.80-85
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    • 2024
  • Lupus anticoagulant hypoprothrombinemia syndrome (LAHPS) is a rare entity characterized by the presence of lupus anticoagulant (LA) and prothrombin (factor II) deficiency. It may cause severe bleeding contrary to classical antiphospholipid syndrome. Here, we report a case of LAHPS presenting with a hemorrhagic ovarian cyst in a 17-year-old girl with systemic lupus erythematosus (SLE) nephritis. She had been followed up for 8 years. Her first manifestation of SLE was prolonged gingival bleeding after tooth extraction at 9 years of age. During the follow-up period, she had neither severe bleeding nor thrombotic complications despite a positive LA and a prolonged activated partial thromboplastin time (aPTT). At this visit, the patient presented with colicky abdominal pain, a hemorrhagic ovarian cyst, a prolonged prothrombin time, a prolonged aPTT, a low factor II level, and a positive LA, leading to the diagnosis of LAHPS. While a hemorrhagic ovarian cyst resolved completely in 3 months, she received oral pill, transfusions of red blood cells and plasma, and intravenous cyclophosphamide pulse therapy in combination with glucocorticoids due to persistent menorrhagia, anemia, prolonged aPTT, and lupus flaring. Thus, LAHPS needs to be considered in SLE patients with positive LA and prolonged aPTT.

Analysis of Factors Affecting Nontherapeutic INRs in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 치료범위를 벗어난 INR 원인분석)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.746-760
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

Wheel Balanced Cancer Therapy for Longer Than 21 Days Can Have a Positive Effect on the Survival of Patients with Stage IV Cancer

  • Jeon, Hyung-Joon;Kim, Jong-min;Cho, Chong-kwan;Lee, Yeon-weol;Yoo, Hwa-seung
    • Journal of Pharmacopuncture
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    • v.18 no.3
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    • pp.19-31
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    • 2015
  • Objectives: Correlations of the levels of the nonspecific inflammatory markers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) and of the coagulation marker fibrinogen with the treatment period of wheel balanced cancer therapy were determined. Methods: Electronic charts of stage IV cancer patients hospitalized from February 1, 2008, to November 30, 2013, were reviewed retrospectively. Patients whose laboratory follow-up tests included at least two data points for at least one marker were included. Patients receiving chemotherapy or radiotherapy or having Eastern Cooperative Oncology Group (ECOG) levels exceeding 2 were excluded. Correlations of the markers with the length of treatment for treatment periods ${\geq}21$ and ${\leq}20$ days were determined by gender and whether or not surgery had been performed. Results: Analyses of the CRP and the ESR revealed a higher proportion of patients with stable marker levels than with increased or decreased levels. Also, only the ESR in female and the CRP in male groups had higher proportions of patients with stable marker levels than with increased or decreased levels. The ${\geq}21$ day group had a higher proportion of patients with stable CRP and ESR levels than the ${\leq}20$ days group. Only the ESR in female and the CRP in male groups had higher proportions of patients with stable marker levels in the ${\geq}21$ day than in the ${\leq}20$ day group. In addition, only the CRP in the surgery group and the ESR in the non-surgery group had higher proportions of patients with stable marker levels in the ${\geq}21$ day group than in the ${\leq}20$ day group. Conclusion: For stage IV cancer patients at hospitals that offer Korean medicine, more than 21 days of long-term wheel balanced cancer therapy (WBCT) should help maintain the CRP and the ESR levels and should have a favorable effect on the survival rate.