• Title/Summary/Keyword: Hemostatic

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Systematic review of self-assembling peptides as topical agents for treatment and prevention of gastrointestinal bleeding

  • Andrei Voiosu;Monica State;Victor Dragan;Sergiu Vaduva;Paul Balanescu;Radu Bogdan Mateescu;Theodor Voiosu
    • Clinical Endoscopy
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    • v.57 no.4
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    • pp.454-465
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    • 2024
  • Background/Aims: Gastrointestinal bleeding is a significant and potentially lethal event. We aimed to review the efficiency and safety of self-assembling peptides for the treatment and prevention of gastrointestinal tract bleeding. Methods: We conducted a systematic search for studies describing the endoscopic use of self-assembling peptides for treatment or prevention of bleeding in the gastrointestinal tract in a parallel, independent fashion. The primary outcomes were rates of successful initial hemostasis, delayed bleeding, and rebleeding. The secondary outcomes were adverse events and ease and volume of gel used. Results: Seventeen studies were analyzed. Overall success rate of self-assembling peptides in gastrointestinal bleeding was 87.7% (38%-100%), regardless of etiology or associated treatments. Rebleeding rate ranged from 0% to 16.2%, with a mean of 4.7%, and overall delayed bleeding rate was 5% (range, 0%-15.9%). Only three adverse events were reported in a pooled number of 815 patients. The volume of gel used varied (0.43 to 3.7 mL) according to indication and type of bleeding. Conclusions: The limited available data on the use of self-assembling peptides in gastrointestinal endoscopy suggest a high efficiency and good safety profile.

Hematologic Changes and Factors Related to Postoperative Hemorrhage Following Cardiopulmonary Bypass (체외순환에 따른 혈액학적 변화와 술후 출혈에 관계하는 인자에 관한 연구)

  • 김하늘루;황윤호;최석철;최국렬;김승우;조광현
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.952-963
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    • 1998
  • Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

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Endoscopic Findings of Upper GI Bleedings in Full Term Newborn Infants (만삭아에서 발생한 상부 위장관 출혈의 내시경적 진단과 치료)

  • Rhim, Suk-Ho;Lee, Hye-Kyung;Min, Yong-Sik;Kim, Han-Jin;Kim, Young-Chang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.142-147
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    • 2001
  • Purpose: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. Methods: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. Results: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. Conclusion: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.

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MILD HEMOPHILIA A DETECTED BY DELAYED BLEEDING: A CASE REPORT (지연된 출혈로 밝혀진 경증 혈우병 A에 대한 증례 보고)

  • Song, Je-Seon;Choi, Byung-Jai;Kim, Seong-Oh;Lee, Jae-Ho;Son, Heung-Gyu;Kim, Hyung-Jun;Choi, Hyung-Jun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.73-76
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    • 2008
  • Hemophilia A is an X-linked disorder resulting from a deficiency in factor VIII. Hemophilia A is classified into severe, moderate, and mild forms. A 12-month old boy visited for uncontrolled bleeding on the upper labial frenum area. Spontaneous bleeding occurred about 13 days ago. We sutured the wound. However, the patient returned after 6 days with large hematoma formation. Consultation to the hematologist and laboratory examination were carried out. Activated PTT was elongated and factor VIII was only 6%. He was diagnosed as mild hemophilia A. Fresh frozen plasma (FFP) was provided and hemostasis was achieved. At 5-day check-up, no more bleeding was observed. For the management of prolonged bleeding in hemophilia A patient, not only local hemostatic measures, but factor VIII replacement therapy, antifibrinolytics, and Desmopressin are also available. Mild hemophilia A often occurs without either familial or medical history. It is often first detected by dental trauma.

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Effect of the Mixture of Thrombin Powder and Gelfoam Powder on Control of Exposed Cancellous Bone Bleeding (Thrombin Powder와 Gelfoam Powder의 혼합물을 이용한 노출된 망상골면 출혈의 지혈효과)

  • Park, Sung Wan;Cho, Ha Young;Lee, Seung Myoung;Jeong, Seong Hun;Song, Jin Kyu;Jang, Suk Jung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.664-667
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    • 2000
  • Objective : Excessive bleeding from the exposed cancellous bone surface may cause serious problem such as hematoma formation, infection, transfusion reaction during operation and postoperative period. There are several kinds of bleeding control agent on the cancellous bone surface including bone wax, gelatin sponge ($Gelfoam^{(R)}$), oxidized cellulose($Oxycel^{(R)}$, $Surgicel^{(R)}$), thrombin, microfibrillar collagen($Avitene^{(R)}$) etc. In the past, bone wax was used to control bone bleeding but it is associated with increased infection rate and fusion failure. Recently, gelfoam paste has been used to control cancellous bone bleeding. We controlled the cancellous bone bleeding with the mixture of gelfoam powder and thrombin powder. Material and Methods : Seventeen patients of posterior fusion on the 4 motion segments of thoracolumbar spine were selected to compare the result of bone bleeding control. In the test group of 9 patients, the cancellous bone bleeding was controlled with the mixture of Gelfoam and thrombin powder during operation. In the control group of 8 cases, no chemical hemostatic agent was used to manage the bone bleeding during operation. We calculated the total amount of bleeding from cancellous bone surface during and after operation in the two groups and compared their statistic significance of the result which was judged by student t-test. Results : The average amount of intraoperative bleeding was 1825ml in control group, 811ml in test group(p<0.01). The amount of postoperative bleeding was 943ml in control group and 812ml in test group, there were no significant difference in the amount of bleeding during postoperative period between two groups(p>0.5). Total amount of blood was decreased in as much as 1150ml in test group(p<0.01). Conclusion : We concluded that the application of the mixture of thrombin and gelfoam powder on the cancellous bone surface is the effective control method of cancellous bone bleeding for multilevel posterior spinal fusion.

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Investigation of the Medicinal Plant Resources (약용식물(藥用植物)의 유전자원수집(遺傳資源蒐集)과 이용(利用)에 대(對)한 조사(調査))

  • Lee, Joon Tak
    • Current Research on Agriculture and Life Sciences
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    • v.8
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    • pp.71-82
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    • 1990
  • In order to collect the plant genetic resources in Korea, the medicinal plants were surveyed from 1987 to 1989 in Kyungbuk province and at the several areas in Kyuognam and Choongbuk province. The medicinal plants of 456 species in 118 families were investigated in these regions. Among them, 249 species were belonged to 19 families, Compositae, Liliaceae, Leguminosae, Poiygonaceae, Labiatae, Rosaceae, Umbelliferae, Gramineae, Solanaceae, Cucurbitaceae, Ranunculaceae, Cruciferae, Rutaceae, Araliaceae, Araceae, Moraceae, Scrophulariaceae, Caryopyhllaceae, and Convolvulaceae, and others were belonged to 99 families. They have been used mostly for urination, gastroenteric disoder, robustness, antiphlogistic, anodyne, cough medicine, fever remedy, hemostatic, and 9 species of them have been used for anticancer medicine. The medicinal plant resources which were planted in the fields, gardens, parks, roadsides, and glass house, were 93 species for ornamental, 50 for medicine, 27 for vegetable, 14 for food, 5 for vegetable fruit, 13 for fruit, 5 for oil, 6 for tea, 9 for shade, and 14 for other purposes. Most of investigated plants were perennial, and flowered from June to August. The root parts were most frequently used as medicine, and other parts were used in the order of leaf and stem, whole plants, flower, seed, and fruit. Among the 456 species, 191 species in 87 families were investigated to be important medicinal plants.

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Somatic Embryogenesis and Organogenesis via Callus Culture from Hydrocotyl maritima Honda (선피막이의 캘러스 배양을 통한 체세포 배발생과 기관분화)

  • Kim, Ok-Tae;Kim, Min-Young;Kim, Kwang-Soo;Ahn, Jun-Cheul;Hwang, Baik
    • Korean Journal of Medicinal Crop Science
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    • v.11 no.5
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    • pp.336-339
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    • 2003
  • Hydrocotyle maritima Honda used as medicinal plants for a hemostatic agent was investigated for in vitro regeneration. The petiole explants of H. maritima were cultured on callus induction medium containing growth regulators ($0{\sim}5\;mg/l$, NAA and $0{\sim}5\;mg/l$ 2,4-D) either in single or in combination with $0.1{\sim}2\;mg/l$ BA for 6 weeks. Although single treatments of 2,4-D or NAA resulted in callus formation, the best results were combination of $0.5\;mg/l$, 2,4-D and $0.5\;mg/l$, BA. $5\;mg/l$, NAA and $0.5\;mg/l$, BA, respectively. The highest number of shoot (12 shoots per callus) was achieved with $3\;mg/l$, Kinetin. Also, when pieces of embryogenic callus induced on the medium supplemented with $0.5\;mg/l$, 2,4-D and $0.5\;mg/l$, BA were subcultured on hormone-free medium, somatic embryos were differentiated and developed further into welldeveloped plants.

Management of Traumatized Gingival Wound Using Tissue Adhesivein Dental Hygiene Practice (치위생 임상에서 조직접착제를 활용한 외상성 치은열창의 처치)

  • Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok
    • Journal of dental hygiene science
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    • v.3 no.1
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    • pp.1-4
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    • 2003
  • The purpose of this paper is to present the potential application of tissue adhesive in the management of traumatized gingival wound in clinical dental hygiene practice. Cyanoacrylate adhesive has been used for closure of superficial laceration without suturing, which is available in periodontal and oral surgery. Small gingival or mucosal lacerations may occur by improper or excessive instrumentation of the dental hygienist during scaling and root planing procedure. In this circumstances, tissue adhesive is very effective, simple, and convenient method as an alternative to conventional wound closure by suturing. The tissue adhesive consists of monomeric n-butyl-2-cyanoacrylate, which polymerizes quickly in contact with tissue fluid. The sutureless treatment of gingival laceration with tissue adhesive has advantages of good esthetic results, less trauma, time saving, antibacterial and hemostatic effects. In addition, local anesthesia as well as re-visit for dressing and removal of suture are not required. Use of tissue adhesive could be beneficial to both dental hygienist and patient in the management of procedural error.

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Evaluation of factors affecting sensory neural hearing loss (감각신경성 청력손실에 영향을 미치는 제 요인에 관한 연구)

  • Hong, Seong-Chul;Bae, Seong-Wook;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.249-264
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    • 1998
  • Reports on a potential relationship between sensory neural hearing loss(SNHL) and cardiovascular or hematologic factor show that the results are controversial. A detailed analysis of risk factors in the development of SNHL was carried out in 3,050 non-noise exposed healthy worker. The mean hearing threshold of both ears at 500, 1000, 2000, 4000, 8000Hz was measured and the effect of age, possible cardiovascular risk factor and hematologic factor (blood viscosity and hemostatic factors) on SNHL were evaluated. first, each of these were associated with loss of hearing sensitivity when univariately and multivariatively analysed. In a multiple regression model, age, sex, body mass index, WBC and total cholesterol level were independently associated with the mean of hearing sensitivity decrease at 4000 and 8000Hz. Second, study subjects were divided into two group (normal vs SNHL) and we compare the possible risk between both groups, and analysed univariate and multivariative logistic model. In a multiple logistic regression model, age, sex, body mass index, WBC and total cholesterol level, total protein, platelet were independently associated with SNHL. Our results show that we have some reliable indices of susceptibility to SNHL using cardiovascular measures or biochemical factor, but future, more extensive studies are required.

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Effect of Nano-sized Carbon Black Particles on Lung and Circulatory System by Inhalation Exposure in Rats

  • Kim, Jong-Kyu;Kang, Min-Gu;Cho, Hae-Won;Han, Jeong-Hee;Chung, Yong-Hyun;Rim, Kyung-Taek;Yang, Jeong-Sun;Kim, Hwa;Lee, Moo-Yeol
    • Safety and Health at Work
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    • v.2 no.3
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    • pp.282-289
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    • 2011
  • Objectives: We sought to establish a novel method to generate nano-sized carbon black particles (nano-CBPs) with an average size smaller than 100 nm for examining the inhalation exposure risks of experimental rats. We also tested the effect of nano-CBPs on the pulmonary and circulatory systems. Methods: We used chemical vapor deposition (CVD) without the addition of any additives to generate nano-CBPs with a particle size (electrical mobility diameter) of less than 100nm to examine the effects of inhalation exposure. Nano-CBPs were applied to a nose-only inhalation chamber system for studying the inhalation toxicity in rats. The effect on the lungs and circulatory system was determined according to the degree of inflammation as quantified by bronchoalveolar lavage fluid (BALF). The functional alteration of the hemostatic and vasomotor activities was measured by plasma coagulation, platelet activity, contraction and relaxation of blood vessels. Results: Nano-CBPs were generated in the range of 83.3-87.9 nm. Rats were exposed for 4 hour/day, 5 days/week for 4 weeks to $4.2{\times}10^6$, $6.2{\times}10^5$, and $1.3{\times}10^5$ particles/$cm^3$. Exposure of nano-CBPs by inhalation resulted in minimal pulmonary inflammation and did not appear to damage the lung tissue. In addition, there was no significant effect on blood functions, such as plasma coagulation and platelet aggregation, or on vasomotor function. Conclusion: We successfully generated nano-CBPs in the range of 83.3-87.9 nm at a maximum concentration of $4.2{\times}10^6$ particles/$cm^3$ in a nose-only inhalation chamber system. This reliable method can be useful to investigate the biological and toxicological effects of inhalation exposure to nano-CBPs on experimental rats.