• Childhood Kidney Diseases
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• 제19권1호
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• pp.43-47
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• 2015

Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.

• 보험의학회지
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• 제32권2호
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• pp.33-38
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• 2013

Coronary artery diseases are very important agenda in the insurance medicine. Insurance medicine is defined as using medical knowledge for insurance administration such as underwriting, claims, and customer satisfaction. This review article contains review of coronary artery disease in terms of insurance medicine. Estimation of extra-risks for acute myocardial infarction are MR of 349% and EDR of 41‰. In medical underwriting, individual life applicants can be assessed by Framingham's CHD risk assessment model. In claims, medical claims review is a useful method of consulting for claims staffs. Several diagnostic criteria of acute myocardial infarction are introduced in time. The universal definition of myocardial infarction by ESC/ACCF/WHF was demonstrated the most valuable predictor of 10-year mortality. Contents for State-Of-The-Art of the coronary artery disease are current antithrombotics. There are many novel anti-thrombotic agents such as ticagrelol, dabigatran, rivaroxaban, and pegnivacogin.

• Journal of Applied Biological Chemistry
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• 제61권3호
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• pp.257-265
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• 2018

The Panax ginseng Mayer is used in conventional medicine in Asia owing to its preventing effects on thrombosis, hypertension, atherosclerosis, vasorelaxation and myocardial infarction. Because platelets are crucial mediators of cardiovascular diseases, many studies have investigated its functions. The previous study showed the antiplatelet effects of crude ginseng fraction and two of its components, ginsenoside Rg3 (20S and 20R). In addition, ginsenoside Rg3-enriched fraction shows an inhibitory effect on collagen-activated rat platelets. However, the mechanism underlying this effect remains unclear. Thus, I investigated the inhibitory action of ginsenoside Rg3 (20S, G-Rg3) on the regulation of signaling molecules involved in ${\alpha}IIb/{\beta}_3$ activation. I found that G-Rg3, in a cyclic AMP dependent manner, inhibited thrombin-induced activation of human platelets and affinity of fibrinogen and fibronectin with ${\alpha}IIb/{\beta}_3$. Thus, in the present study, G-Rg3 showed an inhibitory effect on glycoprotein IIb/IIIa (${\alpha}IIb/{\beta}_3$) activation, suggesting its potential use for preventing platelet-mediated thrombotic disease.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.58-62
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• 2022

Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury without any association with preceding diarrhea. Dysregulation of the complement system is the most common cause of aHUS, and monoclonal humanized anti-C5 antibodies are now recommended as the first-line treatment for aHUS. However, if the complement pathway is not the cause of aHUS, C5 inhibitors are ineffective. In this study, we report the second reported case of aHUS caused by DGKE mutations in Republic of Korea. The patient was an 11-month-old infant who presented with prodromal diarrhea similar to typical HUS, self-remitted with conservative management unlike complement-mediated aHUS but recurred with fever. While infantile aHUS often implies genetic dysregulation of the complement system, other rare genetic causes, such as DGKE mutation, need to be considered before deciding long-term treatment with C5 inhibitors.

• Childhood Kidney Diseases
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• 제2권2호
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• pp.138-144
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• 1998

목 적 : 면역억제제로 사용되는 cyclosporine과 항암제로 사용되는 mitomycin의 신장에 미치는 직접적인 독성여부를 확인하고 이들 약제의 사용으로 초래되는 신장병변의 발생기전을 알아보고자 본 연구를 시행하였다. 대상 및 방법 : 실험동물은 체중 250-300gm의 Sprague-Dawley계 흰쥐를 암수 구별없이 사용하였으며 약물 투여는 Hoyer등이 기술한 방법을 다소 변형한 일측성 신관류 방법을 사용하여 좌측 신장을 대동맥과 대정맥의 혈류로부터 차단하고 좌측 신동맥을 통하여 좌측신을 관류시켰다. Cyclosporine은 4 mL에 2.5 mg, mitomycin은 4 mL에 1.6mg의 농도로 하였고 대조군은 생리적 식염수를 .사용하였으며 혈관 clamping으로부터 감자제거까지 소요된 총 ischemic time은 15분을 초과하지 않았다. 약제 투여후 48시간에 실험 동물을 도살하고 좌측 신장을 적출하여 광학 및 전자 현미경 검사를 시행하였다. 결 과 : Cyclosporine투여군에서는 사구체 내피세포 및 상피세포의 심한 종창이 있었으며 간질내 모세혈관의 내피세포도 심한 종창을 보였다. Mitomycin투여군에서는 사구체 내피세포 및 상피세포의 심한 종창을 보였으며 일부의 모세 혈관에는 혈소판의 응집, 종창 및 탈과립 현상과 섬유소 물질도 포함된 혈전성 미세혈관 병변의 소견을 보였다. 결 론 : Cyclosporine과 mitomycin은 신장 내피세포에 직접적인 손상을 초래하며 그러므로 이들 약제 사용으로 인한 혈전성 미세혈관 병변 (용혈성 요독증)의 발생 기전에는 이들 약제의 신장 내피세포에의 직접적인 손상이 중요한 시발점이 되는 것으로 생각된다.($41.4\%$)이 신초음파에서 이상소견을 보였다. 방광요관역류가 있었던 32명(53역류신장)은 역류정도에따라 Grade $I:25.0\%,\;II:44.5\%,\;III:64.3\%,;IV:92.9\%,\;V:100\%$에서 초기 DMSA 신주사상 이상소견을 보였다. 53역류신장중 전체적으로 DMSA신주사에서 36신장($68.0\%$), 신초음파에서 26신장($49.1\%$)이 이상소견을 보여 유의한 차이를 보였으며(P<0.05). 특히 Grade IV 역류신장에서 유의한 차이가 있었다(P<0.05). 결 론 : DMSA신주사를 이용한 급성신우신염의 진단은 신초음파검사 보다 유용하며, 초기 DMSA신주사 소견상 이상소견을 보인 경우 약 8-12주 후 추적검사를 시행하여 변화를 관찰하고 섭취결손 부분이 남아있는 경우에는 향후 새로운 병소의 출현 혹은 정상화 여부를 보기 위한 추적검사가 필요하리라 사료된다. 방광요관역류 환아에서 DMSA신주사소견은 방광요관역류의 정도가 심할수록 이상소견을 보일 확률이 높으며 신초음파 검사보다 민감도가 높은 것을 알 수 있었다.이는 혈압을 조절시키지 못하였고 저단백식이 항고혈압제투여군은 저단백식이 단독투여군보다 혈압조절 및 단백뇨의 감소 소견은 유의한 차이를 보였으나, mesangial matrix expansion score,대상성 사구체비대는 통계적으로 유의한 차이를 보이지 않았다. 그러므로 만성신부전의 진행을 지연시키는데 있어서 저단백식이와 함께 항고혈압제를 추가하였을 때 항고혈압제에 의한 추가적인 지연 효과는 관찰되지 않았다.학생이 남학생보다 높고, 물리치료과를 타의로

• 대한의생명과학회지
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• 제15권4호
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• pp.273-279
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• 2009

Cordycepin (3'-deoxyadenosine) is an adenosine analogue isolated from Cordyceps militaris, and it has been used as an anti-cancer and anti-inflammation ingredient in traditional Chinese medicine. We investigated the effects of cordycepin on human platelet aggregation induced by thapsigargin, and determined the cytosolic free $Ca^{2+}$ levels ($[Ca^{2+}]_i$), an aggregation-stimulating factor. Cordycepin significantly inhibited thapsigargin-induced platelet aggregation. Its inhibitory effect was continually sustained at the maximal aggregation concentration of thapsigargin. The thapsigargin-induced $[Ca^{2+}]_i$ were clearly reduced by cordycepin in the presence of exogenous $CaCl_2$ or extracellular $Ca^{2+}$-chelator (EDTA). These results suggest that cordycepin inhibited thapsigargin-induced $Ca^{2+}$-influx from extracellular domain and thapsigargin-induced $Ca^{2+}$-mobilization from intracellular $Ca^{2+}$ storage. Accordingly, our data demonstrated that cordycepin may have a beneficial effect on platelet aggregation-mediated thrombotic diseases by inhibiting a $[Ca^{2+}]_i$-elevation.

• Natural Product Sciences
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• 제7권2호
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• pp.53-59
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• 2001

The possibility of Chungpesagan-tang, which has been recommended on the stroke patients with constipation in Korean traditional clinic, and its ingredients as a novel antithrombotic agent was evaluated. Most of its ingredients except Puerariae Radix exhibited in vitro antiplatelet aggregation activity. However, Puerariae Radix was significantly effective on ex vivo anti-platelet aggregation activity, whereas Angelicae Tenuissimae Radix, Raphani Semen and Angelicae Dahuricae Radix was not effective. Plasma recalcification was potently inhibited only by Puerariae Radix and Rhei Rhizoma treated with intestinal bacteria. Urokinase was also activated only by Chungpesagan-tang, Angelicae Tenuissimae Radix and Puerariae Radix treated with intestinal bacteria. Chungpesagan-tang exhibited the potent anti-thromboembolic activity activity in vitro. These results suggest that anti-thrombotic activity of Chungpesagan-tang should be activated by intestinal bacteria and may be important in the prevention of thrombosis and cardiovascular diseases, such as myocardial infraction stroke and arteriosclerosis.

• 대한의생명과학회지
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• 제25권4호
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• pp.302-312
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• 2019

The aim of this work was to investigate the effect of black tea extract (BTE) on collagen -induced platelet aggregation. In this study, BTE (10~500 ㎍/mL) was shown to inhibit platelet aggregation via thromboxane A₂ (TXA₂) down-regulation by blocking cyclooxygenase-1 (COX-1) activity. Also, BTE decreased intracellular Ca²⁺ mobilization ([Ca²⁺]_i). Additionally, BTE enhanced the levels of both cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), which are aggregation-inhibiting molecules. BTE inhibited the phosphorylation of phospholipase C (PLC) γ2 and syk activated by collagen. BTE regulated platelet aggregation via cAMP-dependent phosphorylation of vasodilator-stimulated phosphoprotein (VASP) Ser¹⁵⁷. The anti-platelet effects of BTE in high fat diet (HFD)-induced obese rats were evaluated. After eight weeks of BTE treatment (300 and 600 mg/kg), the platelet aggregation rate in the treated groups was significantly less than that in the HFD-fed control group. Also, BTE exhibited a hepatoprotective effect and did not exert hepatotoxicity. Therefore, these data suggest that BTE has anti-platelet effects on collagen-stimulated platelet aggregation and may have therapeutic potential for the prevention of platelet-mediated thrombotic diseases.

• Journal of Ginseng Research
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• 제32권2호
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• pp.89-98
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• 2008

There are increasing evidences in the literatures on the potential role of ginsenosides in treating cardiovascular diseases. In this article, current information about ginsenosides-mediated vascular relaxation are reviewed. From the published studies using isolated organs, cell culture systems and animal models, ginsenosides are shown to relax blood vessels and improve blood flow through diverse mechanisms, including nitric oxide release by activating eNOS phosphorylation via PI3K/Akt and/or ERK1/2 pathways in endothelial cells, induction of inducible nitric oxide synthase through activation of NF-${\kappa}$B, reducing the intracelluar Ca$^{2+}$ levels by activating Ca$^{2+}$-activated K$^{+}$ channels in vascular smooth muscle cells and reducing platelet aggregation by decreasing thromboxane A$_2$ formation and intracelluar Ca$^{2+}$in platelets. In addition, the relevant clinical trials regarding the effects of ginsenosides on the cardiovascular disease are summarized, particulary focusing on managing hypertension and improving thrombotic disorders. Finally, antagonistic effects of ginsenosides on the prostaglandin H$_2$ receptor and scavenging effects on the generation of oxygen-derived free radicals in spontaneously hypertensive rats (SHR) are discussed.

• Journal of Chest Surgery
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• 제44권5호
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• pp.364-367
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• 2011

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.