• Title/Summary/Keyword: Epistaxis

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Inhibitory Effect of Dioscorea Bulbifera MeOH Extract on Pro-inflammatory Mediator In Vitro and In Vivo (황약자(黃藥子) 메탄올 추출물의 염증억제 효과)

  • Jung, Ji-Yun;Lee, Jong-Rok;Byun, Sung-Hui;Jung, Ji-Wook;Kim, Yong-Han;Kim, Sang-Chan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.2
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    • pp.310-318
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    • 2010
  • Dioscorea bulbifera is one of the traditional medicinal herb. It commonly used in the treatment of hematemesis, epistaxis, tuberculous cervical lymphadenitis, laryngitis, acute infectious disease in East Asia. In the present study, we have demonstrated the anti-inflammatory effects of Dioscorea bulbifera MeOH extract (DBME) in macrophage cell line. To investigate mechanism of the anti-inflammatory activity, we examined the effects of the lipopolysaccaride (LPS)-induced production of nitric oxide (NO), prostaglandin $E_2$ ($PGE_2$), pro-inflammatory cytokines and expression of inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), p-inhibitory ${\kappa}B{\alpha}$ (p-$I{\kappa}B{\alpha}$), and nuclear factor-${\kappa}B$ (NF-${\kappa}B$) in a murine macrophage cell line RAW 264.7. The RAW 264.7 cells were cultured in DMEM + serum medium for 24 hrs. After serum starvation for 24 hrs, the cells were treated with DBME 0.03, 0.10, 0.30 mg/$m{\ell}$ for 1 h, followed by stimulation with LPS (1 ${\mu}g/m{\ell}$) for activation of immune response. After treatment, cell viability was measured by MTT assay, and NO production was monitored by measuring the nitrite content in culture medium. The protein band of iNOS, COX-2, p-$I{\kappa}B{\alpha}$, and NF-${\kappa}B$ was determined by immunoblot analysis and levels of cytokine were analyzed by sandwich immunoassays. There were three experimental groups: carrageenan, DBME 0.3, 1.0 g/kg. Rats were administrated either carrageenan (40% PEG) or carrageenan + DBME (0.3, 1.0 g/kg body weight) for 4 days (p.o.). To induce acute paw edema, rats were injected 1% carrageenan (100 ${\mu}{\ell}$/rat, dissolved in sterilized saline). The effect of DBME in the carrageenan-induced rat paw edema. As results, DBME has an inhibitory effect on the production of NO, PGE2, TNF-${\alpha}$, IL-$1{\beta}$ and IL-6 and on the expression of iNOS, COX-2, p-$I{\kappa}B{\alpha}$ and translocation of NF-${\kappa}B$ to nuclear from cytosol. In addition, DBME effectively inhibited the increases of paw edema induced by carrageenan treatment in vivo. These results suggest that DBME can inhibit production of pro-inflammatory mediators and might be a useful source for treatment of acute inflammatory disease.

Evaluation of Inflammatory Disease in the Nasal Cavity and Paranasal Sinuses using CT in Dogs and Cats (개와 고양이에서 컴퓨터단층촬영술을 이용한 비강의 염증성 질병 평가)

  • Choi, Ho-Jung;Lee, Ki-Ja;Park, Seong-Jun;Jeong, Seong-Mok;Song, Kun-Ho;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.42-45
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    • 2010
  • Inflammatory sinonasal disease was diagnosed in five dogs and two cats with clinical signs of nasal discharge and epistaxis. Survey radiography and CT were performed in all of patients. CT scan of the rostral cranium was performed with a thickness of 2 or 5 mm. Nasal cytology and culture from nasal smear were performed immediately after CT examination. Remarkable increase of opacity in the nasal cavities and frontal sinuses was observed in only 3 cases. On CT images, the cavitating lesions were isodense in nasal cavity (7 cases), frontal sinuses (3 cases), and nasopharynx (2 cases) with destruction of the nasal septum (4 cases), maxillary turbinates (5 cases), maxilla (3 cases), and hard palate (3 cases). The lesions were enhanced after intravenous contrast administration in 5 cases and were not enhanced in 2 cases. Inflammatory cells were observed in nasal cytology. Most of the cultures from nasal smear were bacteria. CT is useful to diagnose sinonasal disease and is more accurate in demonstrating the extent and character of lesions of nasal cavity than radiography.

Palliative Surgery in Two Dogs with Non-Curative Palatal Tumors (두 마리 개에서 완치가 어려운 구개 종양의 완화 수술 적용 증례)

  • Yoon, Hun-Young;Lee, Jung-Ha;Shin, Dong-Wook;Park, Hee-Myung;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.425-429
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    • 2014
  • Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.

Low-intensity Oral Anticoagulation Versus High-intensity Oral Anticoagulation in Patients with Mechanical Bileaflet Prosthetic Heart Valves (이엽성 기게 심장판막 환자에 대한 낮은 강도의 항응고제 요법의 결과에 대한 임상분석)

  • Jeong, Seong-Cheol;Kim, Mi-Jung;Song, Chang-Min;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Byung-Yul
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.430-438
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    • 2008
  • Background: All the patients with mechanical valves require warfarin therapy in order to prevent them from developing thromboembolic complications. According to the ACC/AHA practice guidelines, after AVR with bileaflet mechanical prostheses in patients with no risk factors, warfarin is indicated to achieve an INR of 2.0 to 3.0. After MVR with any mechanical valve, warfarin is indicated to achieve an INR of 2.5 to 3.5. But in our clinical experience, bleeding complications (epistaxis, hematuria, uterine bleeding, intracerebral hemorrhage etc.) frequently developed in patients who maintained their INR within this value. So, we retrospectively reviewed the patients with bileaflet mechanical heart valve prosthesis and we determined the optimal anticoagulation value. Material and Method: From January 1984 to February 2007, 311 patients have been followed up at a national medical center. We classified the AVR patients (n=60) into three groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II and an INR from 2.5 to 3.0 in Group III. We classified the MVR (n=171) and DVR (n=80) patients into four groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II, an INR from 2.5 to 3.0 in Group III and an INR from 3.0 to 3.5 in Group III. We compared the groups for their thromboembolic and bleeding complications by means of the Kaplan Meier method. Result: In the AVR patients, 2 thromboembolic complications and 4 bleeding complications occurred and the log rank test failed to identify any statistical significance between the groups for thethromboembolic complication rate, but groups I and II had lower bleeding complication rates than did group III. Thirteen thromboembolic complication and 15 bleeding complication occurred in the MVR and DVR patients, and the log rank test also failed to identify statistical significance between the groups for the thromboembolic complication rate, but groups I and II had lower bleeding complication rates that did groups III and IV. Conclusion: The thromboembolic complication rate was not statistically different between groups I and II and groups III and IV, but the bleeding complication rates of groups I and II were lower than those of groups III and IV. So this outcome encouraged us to continue using our low intensive anticoagulation regime, that is, an INR of 1.5 to 2.5.