• Title/Summary/Keyword: Low-Molecular-Weight Heparin

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Herpes zoster complicated by deep vein thrombosis: a case report (대상포진에 합병된 심부정맥혈전증 1예)

  • Choi, Woo-Yeon;Cho, Young-Kuk;Ma, Jae-Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.607-610
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    • 2009
  • Varicella zoster virus (VZV) causes two diseases: Varicella, a generalized, primary infection, and herpes zoster (zoster), a secondary infection caused by latent VZV reactivation. Zoster can also be caused by latent VZV reactivation after a varicella vaccination. The complications associated with varicella include cutaneous infections, which are the most common, as well as pulmonary and neurological involvement. However, a deep venous thrombosis (DVT) has been rarely described as a varicella-associated complication. Here, we describe the case of a child with varicella zoster who developed a DVT that completely resolved after intravenous acyclovir and subcutaneous low-molecular-weight heparin treatment.

Sural Artery Flap for Skin Defect of Lower Legs (비복동맥 피판술을 이용한 하지 피부결손의 치료)

  • Jin, Jin-Woo;Yoon, Jong-Ho;Jung, Sung-Weon;Paeng, Jung-Wook
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.119-124
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    • 2007
  • Purpose: We reconstructed the skin defect of lower legs exposing muscles, tendons and bone with fasciocutaneous sural artery flap and report our cases. Materials and Methods: Between March 2005 and September 2006, 8 cases of skin defect were reconstructed with fasciocutaneous sural artery flap. Defect site were 4 case of ankle and foot and 4 cases of lower leg. The average defect size was $4{\times}4\;cm^2$. There were 5 men and 3 women and mean age was 52.2 years. We evaluated the viability of flap, postoperative complication, healing time, patient's satisfaction. Results: There was no flap failure in 8 cases. But recurrent discharge in 2 cases was healed through several times adequate debridement and delayed suture without complication. Flap edema may be due to venous congestion was healed through leg elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence in follow up period. Cosmetic results as judged by patients were that 5 cases are good and 3 cases are fair. Conclusion: Sural artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Sural artery flap is useful method for the skin defect of lower legs because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

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Distally based Ulnar Artery Flap for Reconstruction of Hands (척골동맥 피판술을 이용한 수부 재건술)

  • Ahn, Byung-Woo;Yoon, Jong-Ho;Jung, Sung-Weon;Kim, Ki-Hwan
    • Archives of Reconstructive Microsurgery
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    • v.17 no.2
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    • pp.115-119
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    • 2008
  • Purpose: We reconstructed the skin defect of hands exposing tendons and/or bone with distally based ulnar artery flap and report our cases. Materials and Methods: Between March 2005 and September 2007, 6 cases of skin defect were reconstructed with distally based ulnar artery flap. Defect site were 5 cases of hand dorsal side and 1 case of hand volar side. The average defect size was $3{\times}3\;cm^2$. There were 4 men and 2 women and mean age was 55.5 years. We evaluated the viability of flap, postoperaive complication, healing time, patient's satisfaction. Results: There was no flap failure in 6 cases. But 1 case with recurrent discharge was healed with several times adequate debridement and delayed suture. 1 case with flap edema which might be due to venous congestion was healed with hand elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence was found in follow up period. Cosmetic results as judged by patients were that 3 cases are good and 3 cases are fair. Conclusion: Distally based ulnar artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Distally based ulnar artery flap is useful method for the skin defect of hands because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

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Effects of Glucose on Insulin-like Growth Factor Binding-5 Expression in Human Fibroblasts. (사람의 섬유아세포에서 Glucose 농도가 Insulin-like Growth Factor Binding Protein-5의 발현에 미치는 영향)

  • Ryu, Hye-Young;Hwang, Hye-Jung;Kim, In-Hye;Ryu, Hong-Soo;Nam, Taek-Jeong
    • Journal of Life Science
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    • v.17 no.9 s.89
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    • pp.1224-1231
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    • 2007
  • Insulin-like growth factor-I (IGF-I) and IGF-II have structure like insulin. In contrast to insulin, however, the bioavaility of IGFs is modulated by the IGF-binding protein (IGFBPs). Each of IGFBPs was different with molecular masses, biological characteristics, and immunological properties.. Human fibroblasts secrete IGFBPs that can modify IGF-I action. In diabetes mellitus, the most study of IGF systems have been investigated in insulin-dependent diabetes mellitus, non-insulin-dependent diabetes mellitus, and streptozotocin-in-duced animals in vivo. Recently, a little research regarding the IGFs system has been proposed in por-tion of cell in vitro. In this study, effects of low or high glucose condition on IGFBP-5 in GM10 was investigated. By western blotting analysis, IGFBP-5 level decreased in cells cultured at high glucose, but IGFBP-5 level of mRNA didn't change. IGFBP-5 protease that cleaves IGFBP-5 in conditioned me-dium had was inhibited by EDTA and heparin, like serine protease and metalloprotease. Furthermore, the protease activity was increased in high glucose cultivated condition. In results of gelatin zymog-raphy, molecular weight of proteolytic metalloenzymes was indentified 69-kDa and protease activity was increased in time-dependent manner. Although the mechanism has yet to be determined, IGFBP-5 proteolysis in GM10 cells cultured with high glucose may increase effects of IGFs to decrease the glu-cose level through dissociation of IGFs from IGFBPs. Therefore, we suggest that IGF- I and IGFBPs could be potential models in study of pathophysiology such as diabetes mellitus.

Deep Vein Thrombosis in Advanced Cervical Cancer Patient after Taking Cyclooxygenase-2 Selective Inhibitors (Cyclooxygenase-2 선택적 억제제를 복용 중 자궁암 환자에 발생한 심부정맥혈전증 1예)

  • Ko, Byung-Joon;Kim, Su-Hyun;Kim, Jeong-A;Hong, Jeong-Ik;Yoon, Do-Kyoung;Kim, Jung-Hwan;Sohn, Keun-Ju;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.57-64
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    • 2005
  • Cyclooxygenase-2 (COX-2) selective inhibitors were specifically developed to reduce the risks of gastrointestinal bleeding associated with other NSAID drugs. However, the APPROVe (Adenomatous Polyp Prevention on VIOXX) trials revealed that rofecoxib sometimes exerts prothrombotic effects. Meanwhile, cancer patients, who also carry a risk of thrombosis due to a variety of mechanisms, are often treated with COX-2 selective inhibitors, due to their relative gastrointestinal safety. This report concerns the case of a 46-year old woman with advanced cervical cancer, who had been treated with opioids and a COX-2 selective inhibitor (celecoxib) for 2 months, for the relief of pain associated with her cancer. The patient was admitted due to swelling of the left leg, which was also accompanied by pain. A computerized tomography scan revealed deep vein thrombosis occurring in multiple veins of both legs. After the administration of low-molecular weight heparin and oral warfarin, the patient's symptoms were relieved initially. However, her prothrombin time was found to be prolonged, necessitating the discontinuation of anticoagulation therapy. The patient's dyspnea worsened, ultimately resulting in her death. In conclusion, the administration of cox-2 selective inhibitors should be carefully considered in patients with a number of different risk factors, and assessed on a case-by-case basis.

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A Study on the Types and Causes of Medication Errors and Related Drugs - by Analyzing AJNs Medication Error 73 Cases - (임상에서의 투약오류원인과 관련 의약품 분석 - AJN에 기고된 Medication Error 기사의 73사례를 중심으로 -)

  • Cho Won Sun
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.176-189
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    • 2002
  • The purpose of this study were to illustrate the various medication error types and causes and identified to related drugs to provide basic data for preventing nurses' medication error by analysing 73 cases of AJN 'medication Error' column(1993, Oct -2000, Nov). Nurses' types of medication error were classified into 7 types. The most frequent error types are wrong medication$(21.9\%)$ and the wrong dose$(21.9\%)$ together. The others are wrong $time(4.1\%)$, $omission(2.7\%)$, mechanical $error(2.7\%)$, incorrect IV $rate(1.4\%)$. wrong route $administration(1.4\%)$ in order. Nurses' causes of medication error were 9 kinds. The most frequent type is confusing between similar drug shape, color, size, name, injection devices and patient's $name(43.9\%)$ and the others are lack of knowledge about $drugs(26.8\%),\; slips(7.3\%),\; miscalculating\;dose(4.9\%)$, incorrect adjusts $devices(4.9\%)$, difficulty to read or illegible decimal $point(4.9\%),$ $abbreviation(2.4\%)$, fatigue with $overwork(2.4\%)$ and no communication with $patient(2.4\%)$ in order. Related drugs with medication error are as follows. - dose unit(IU. minims. mcg/min. mEq) : Heparin. insulin. synthetic calcitonin, some enzymes and hormones, vitamins, some antibiotics, tuberculin injection. MgSO4 injection. nitroglycerin - similar size, color and shape drug : $0.9\%$ N/S and acetic acid $0.25\%$ for irrigation. premixed 2mg lidocaine sol. and $0.9\%$ N/S, gentamycin 20mg/2mL for children and 80mg/2mL for adult, dextroamphetamine 5mg and 10mg capsule. sedatives chloral hydrate 250mg/5mL and 500mg/5mL - similar name :Aredia(pamidronate disodium) and Adriamycin(doxorubicin), Lamictal (lamotrigine) and Lamisil 250mg. Elderpryl and enalapril, cefotaxime and cefoxitin, carboplatin and cisplatin, sumatriptan and zolmitriptan, Celebrex and Celexa, Humulin and Humalog, Percodan and Percocet, Diabeta and Diabinese, Epivir and Retrovir, Xanax(alprazolam) and Zantac(ranitidine) - decimal point : low molecular weight warfarin, methotrexate - unfamiliar drug uses of familiar drug ; methotrexate. droperidol, imipramine, propranolol - number of drug name(misleading chemical name) : 6-thioguanine, 6-mercaptopurine, 5-fluorouracil - type of administration route : Oxycodone(OxyContin). - administration time : acarbose(Precose). - injection way (Z-track method): hydroxyzine - epidural cathether : LMWHs(enoxaparin, dalteparin), - ADD Vantage self contained delivery system : ceftriaxone(Rocephin)

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