• 대한수의학회지
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• 제58권3호
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• pp.119-124
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• 2018

This study was conducted to compare the hemostatic efficacy of three ferric subsulfate- and chitosan-based styptics as a powder and a gel containing ferric subsulfate and chitosan (FSC-PO and FSC-G, respectively) and a soaked pad containing ferric subsulfate and lidocaine (FSL-SP) using a rat tail bleeding model. The cytotoxicity of the styptics against L-929 mouse fibroblasts was also evaluated using a cell counting kit-8 assay. Four groups of 10 rats each were assigned to the three different styptics and a non-treated control groups. Rat tail tips were transected, after which styptics were applied with pressure. The wounds were observed for hemostasis for 3 min, then irrigated with saline to check for recurrent hemorrhage. L-929 mouse fibroblasts were exposed to extracts of the styptics (100 mg/mL) and their dilutions (1:10, 1:100, and 1:1,000). FSC-PO and FSC-G more effectively controlled initial hemorrhage than FSL-SP (p = 0.033). Additionally, FSC-PO and FSC-G more effectively maintained hemostasis than the control group (p = 0.02 and p < 0.01, respectively). However, all styptics showed enhanced cytotoxicity against L-929 cells in a dose-dependent manner. Therefore, although FSC-PO and FSC-G would be recommended to control hemorrhage, the benefits of styptics must be balanced against the clinical significance of their cytotoxicity.

• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.153-156
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• 2011

Objective : This prospective, non-randomized study compared the safety and efficacy of the Angio-$Seal^{TM}$ $Evolution^{TM}$ to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography. Methods : From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-$Seal^{TM}$ $Evolution^{TM}$ or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment. Results : Mean time to hemostasis was $0.42{\pm}0.04$ minutes for the angioseal and $15.83{\pm}1.63$ minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications. Conclusion : The Angio-$Seal^{TM}$ $Evolution^{TM}$ is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.

• 대한수의학회지
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• 제50권3호
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• pp.247-251
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• 2010

This study compared the instrument performance and tissue healing of a steel scalpel with a $CO_2$ laser in an animal urinary bladder surgery model. Landrace and Yorkshire mixed breed pigs were used. Two symmetrical incisions were made in urinary bladder of each pig. One incision was made on the left side of ventral aspect on urinary bladder using a steel scalpel, while the other incision was performed on the right side using a $CO_2$ laser with an 8W output power. Each instrument was evaluated clinically for speed, ease of incision, and extent of bleeding. At 7 and 21 days after initial wounding, each wound was taken for histological observations. The scalpel was an easier instrument to use in the confines of the urinary bladder tissue, compared with the laser. However, there was no significant difference between the two groups. The amount of bleeding was less in the laser group but the time of the incisions was shorter with the scalpel. Scalpel incisions showed complete restoration of the epithelium and muscularis. On the other hand, the laser incisions showed incomplete restoration of the epithelium and muscularis. However, most of wound healing in the laser incisions was accomplished according to the time lapse. Although the scalpel produced less damage to the urinary bladder tissue and was easier to handle than the $CO_2$ laser, it did not provide hemostasis that was helpful for use on highly vascular tissue. The $CO_2$ laser provided good hemostasis, but delayed wound healing. In conclusion, the $CO_2$ laser provided better hemostasis and better surgical field than the scalpel. The $CO_2$ laser was used effectively in urinary bladder incision.

• Journal of Chest Surgery
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• 제29권2호
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• pp.185-190
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• 1996

The effect of low-dose aprotinin on hemostasis in patients undergoing cardiopulmonary bypass (CPB) for repeat valve replacement and coronary artery bypass operations were investigated. Thirty patients undergoing elective CPB from February 1993 through February 1995 at Catholic Medical Center were studied. the patients were randomly divided into two groups(15 patients per group) : group 1, receive 1, 000, 000 KIU/kg aprotinin in the CPB priming volume and 20, 000 KIU/kg aprotinin intravenously each hour during CPB ; group 2, without aprotinin administration served as the controls. The result showed that the early postoperative (during the first 24 hours) and mean postoperative total blood loss of the aprotinin group were significantly reduced than the control group (317.2 $\pm$ 89.6ml in the aprotinin group versus 821.3 $\pm$ 441.2rnl in the control group, p<0.01 ; 767.2 $\pm$ 214.1 ml in the aprotinin group versus 1562.5 $\pm$ 735.2 rnl in the control gorup, p<0.01). Total use of packed red ells and fresh frozen plasma was higher in control group(1.22 $\pm$ 0.3 units versus 4.21 $\pm$ 1.7units of packed red cells, p<0.01 : and 2.37 $\pm$ 0.4units versus 6.72 $\pm$ 0.88uni1s of fresh prozen plasma, p<0.05). We conclude the low-dose aprotinin was positive influence on postoperative blood loss in undergoing highly bleeding potency cardiac operation.

• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.1-4
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• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

• 접착 및 계면
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• 제24권4호
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• pp.113-119
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• 2023

홍합의 수중 접착능력은 도파(DOPA)와 라이신(Lysine), 히스티딘(Histidine)과 같은 홍합접착단백질의 아미노산 잔기가 중요한 역할을 한다고 보고되었고, 이에 따라, 카테콜과 아민기를 동시에 갖는 접착성 카테콜아민(Catecholamine) 물질을 기반으로 다양한 의공학적 연구가 진행되고 있다. 카테콜기가 도입된 키토산은 아민이 풍부한 키토산에 카테콜기를 도입한 카테콜아민으로, 이를 이용하여 조직접착제나 창상치유제, 지혈제, 약물전달체 및 조직공학용 담체 등 다양한 의공학적 적용이 가능하다. 특히, 키토산-카테콜 물질은 지혈제로 미국 및 한국 식품의약품안전처의 승인을 받아, 연구개발에서부터 제품개발까지 이루어진 홍합 모사 물질이다. 이에 본 총설에서는 지혈제로써의 키토산-카테콜 물질에 대한 연구 동향을 살펴보고자 한다. 이를 위해, 카테콜기가 도입됨에 따라 나타나는 키토산-카테콜의 특성, 지혈 메커니즘, 다양한 제형에 대하여 다루고자 한다.

• 대한한의학회지
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• 제19권1호
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• pp.179-204
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• 1998

The purpose of this research was to investigate the efficacy of Goiwhasan extract powder on the gastric injuries, antiulcer, gastrointestinal tract and blood hemostasis. Animals were used through this studies mice and rats. All animals were divided into 3 groups, contol group(no treatment), sample Ⅰ group(375mg/kg administration), sample Ⅱ group(750mg/kg administration). The gastric injuries and ulcer have been made by using pyloric ligation, indomethacin, HCI-ethanol, acetic acid and then The histological observation was followed. In the gastrointestinal tract, gastric juice secretion, gastric acidity, pepsin output, blood gastrin and secretin level, transport potentials in the small and large intestine were checked. And studies on blood hemostasis were performed on normal hemostatic activities and plasma prothrombin time, plasma recalcification time, plasma fibrinogen levels in the hypoprothrombinemic mice induced by warfarin. The results were as follows: 1. The antigastric ulcer effects on the pyloric ligation, indomethacin, HCl-ethanol, acetic acid induced gastric injuries were shown in Sample Ⅱ group(p<0.05). 2. Through the morphologic examination on the acetic acid induced ulcer, Sample Ⅰ group showed mild regeneration of epithelium and slight decrease of periulcer edema then that of Control group, while Sample Ⅱ group showed more retraction of round ulcer site, remarkable loss of swelling and edema then that of Control group, and revealing the regenerated epithelium in the surrounding ulcer site. Thus it was noted that both Sample groups have antigastriculcer effects on the experimentally induced gastric ulcer. 3. The inhibitory effects on gastric juice were noted in both Sample Ⅰ group(p<0.05) and Sample Ⅱ group(p<0.01). However, only Sample Ⅱ group showed the inhibitory effects on total acidity and pepsin output(p<0.05). 4. The significant inhibition of blood gastrin level showed at 30 min.(P<0.05) and 90 min.(P<0.05) after starting medication in only Sample Ⅱ group, but significance of blood secretin level in both groups was not recognized. 5. Any significant changes in barium sulfate transport in the small intestine of mice was not recognized in both groups, but the significantly inhibitory effect in large intestine was recognized in both Sample Ⅰ group(p<0.05) and Sample Ⅱ group(p<0.001). 6. In hemostatic effect on both normal mice and hypoprothrombinemic mice induced by warfarin, the significantly shortening effect on coagulation time was seen in only Sample Ⅱ group(p<0.01). 7. On plasma prothrombin time in hypoprothrombinemic rat induced by warfarin, Sample Ⅱ group have shortened the prothrombin time significantly(p<0.001). 8. On plasma reclcification time in hypoprothrombinemic rat induced by warfarin, the recalcification time have been shortened significantly in both Sample Ⅰ group(p<0.05) and Sample Ⅱ group(p<0.01). 9. On plasma fibrinogen levels in hypoprothrombinemic rat induced by warfarin, the fibrinogen contents in Sample Ⅱ have been decreased significantly(p<0.01). Overall the above results suggest that Goiwhasan has an therapeutic efficacy on antigastric ulcer and blood hemostasis. Further studies would be needed on the interaction of its herbal medicine and its mechanism in the future.

• Journal of Chest Surgery
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• 제20권4호
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• pp.683-687
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• 1987

Bleeding from bone marrow after sternotomy for open cardiac surgery can be sometimes difficult to control and even lead to reoperation for hemostasis. A clinical comparative study was carried out to demonstrate the hemostatic effect of fibrin glue [Beriplast] for sternal marrow bleeding after sternotomy for open heart surgery. Postoperative blood loss was measured in two patient groups, group A included 19 patients operated upon from June to October 1987 and the fibrin glue was applied to the sternal marrow together with collagen fleece and group B consisted of 22 patients from January to May 1987 and only collagen fleece was applied without fibrin glue. There was no difference between two groups in age and sex distributions, coagulation state, method of extracorporeal circulation and operative management. The blood loss one hour after operation was 2.04 ml/hr/kg in group A and 3.55 ml/hr/kg in group B [P<0.001]. The most significant difference was observed during the first 4 hours after surgery with 1.34 ml/hr/kg versus 2.05 ml/hr/kg. over the following 20 hours the amount of drainage from the chest tubes was identical in both groups. Fibrin glue reduces blood loss after open heart surgery by local hemostasis at sternum. Our study has shown that local application of fibrin glue to sternal marrow is an effective method of controlling the sternal bleedings. No side effect or complication of fibrin glue was noted.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.134-137
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• 2017

Gastric hemangioma in the neonatal period is a very rare cause of upper gastrointestinal bleeding. We present a case of hemangioma limited to the gastric cavity in a 10-day-old infant. A huge, erythematous mass with bleeding was observed on the lesser curvature side of the upper part of the stomach. Surgical resection was ruled out because the location of the lesion was too close to the gastroesophageal junction. Medical treatment with intravenous $H_2$ blockers, octreotide, packed red blood cell infusions, local epinephrine injection at the lesion site, application of hemoclip, and gel-form embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis was achieved with endoscopic argon plasma coagulation (APC). After two sessions of APC, complete removal of the lesion was achieved. APC was a simple, safe and effective tool for hemostasis and the ablation of gastric hemangioma without significant complications.

• 대한한의학회지
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• 제37권2호
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• pp.104-109
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• 2016

Objectives: A 74-year-old male patient with unresectable advanced gastric cancer (clinical initial stage T3N+, Borrmann type III) admitted due to gastric bleeding at tumor site. On first admission day, hemoglobin level was 5.7g/dl and performance status was grade 3 according to Eastern Cooperative Oncology Group Performance Status(ECOG-PS). After performing red blood cell transfusion as an emergency treatment, hemoglobin level was increased up to 9.5g/dl. However, bleeding of oozing site was continued. For hemostasis, decoction of notoginseng radix (30g/day) was administered since day 7 after admission. The dose was elevated to 40g/day after hemoglobin level was decreased to 6.5g/dl on day 11. Since then, melena was stopped and hemoglobin level was maintained over 9.1g/dl. This case shows the hemostasis effect of decoction of notoginseng radix on gastric bleeding in unresectable advanced gastric cancer.