• Title/Summary/Keyword: Thrombotic diseases

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Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol

  • Marangi, Giovanni Francesco;Segreto, Francesco;Poccia, Igor;Campa, Stefano;Tosi, Daniele;Lamberti, Daniela;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • v.43 no.4
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    • pp.360-364
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    • 2016
  • Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.

Two Cases of Acute Renal Failure Complicating Paroxysmal Nocturnal Hemoglobinuria in Children (급성 신부전을 동반한 발작 야간 혈색소뇨증 2례)

  • Ryu, Jung-Min;Ahn, Yo-Han;Lee, So-Hee;Choi, Hyun-Jin;Lee, Beom-Hee;Kang, Hee-Gyung;Kang, Hyoung-Jin;Shin, Hee-Young;Ha, Il-Soo;Cheong, Hae-Il;Ahn, Hyo-Seop;Choi, Yong
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.221-226
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    • 2008
  • Paroxysmal nocturnal hemoglobinuria(PNH) is an acquired hematologic disorder characterized by intravascular hemolysis, nocturnal hemoglobinuria, thrombotic events and bone marrow failure. It rarely occurs in children and can be complicated by acute renal failure(ARF). Here, we present two cases of ARF complicating PNH which has not been reported yet in Korean children. We suggest that PNH should be considered in differential diagnosis of ARF in children associated with intravascular hemolysis.

Effects of Aqueous Extract of Diospyros Kaki Calyx on Anti-thrombotic Activity in vitro and in vivo (시체(柿蒂)의 in vitro와 in vivo 항혈전 효능 연구)

  • Baek, Kyung-Min;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.26 no.4
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    • pp.139-147
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    • 2011
  • Objectives : The aim of this study is to research an anti-thrombus effect by Diospyros Kaki Calyx. Methods : The healthy human plasma were gained and used in vitro study such as factor X activity (FXa) inhibition, prothrombinase inhibition, prothrombin time (PT) and activated partial thromboplastin time. Fifteen SD rats were divided into three groups ; intact control group (orally administrated with distilled water 5ml/kg) and two experimental group treated with extract of diospyros kaki calyx (EKC). Experimental rats were orally 600 mg/kg concentration of EKC and 200 mg/kg concentration of EKC. After an hour from administration, we anesthetized rats and made arteriovenous (AV) shunt rat models to study weight of thrombus, took whole blood to study content of thromboxane B2 and blood clotting time. Results : In vitro, EKC significantly increased inhibitory activity of FXa, prothrombinase compared with intact control group ($^*P$ <0.05). PT and aPTT were increased in EKC treated (600 mg/kg) group compared with intact control group ($^*P$ <0.05). In vivo, blood clotting time of experiment group treated with EKC 600 mg/kg were significantly increased compare with that of intact control group (p<0.05) and content of thromboxane B2 was significantly decreased in group treated with EKC 600 mg/kg in serum. The weight of thrombus were significantly reduced in group treated with EKC 600 mg/kg compared with intact control group (p<0.05). But in vivo experiment study, those parameters of group treated with EKC 200 mg/kg were relatively decreased compared with those of intact control group without statistical significance. Conclusions : EKC has an antithrombic activity because of inhibition internal course such as FXa and prothrombin. And EKC inhibited a hole blood clotting in vivo experiment by low content of thromboxane B2.

Total Saponin from Korean Red Ginseng Inhibits Thromboxane A2 Production Associated Microsomal Enzyme Activity in Platelets

  • Lee, Dong-Ha;Cho, Hyun-Jeong;Kang, Hye-Yeon;Rhee, Man-Hee;Park, Hwa-Jin
    • Journal of Ginseng Research
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    • v.36 no.1
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    • pp.40-46
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    • 2012
  • Ginseng, the root of Panax ginseng Meyer, has been used frequently in traditional oriental medicine and is popular globally. Ginsenosides, which are the saponins in ginseng, are the major components having pharmacological and biological activities, including anti-diabetic and anti-tumor activities. In this study, we investigated the effects of total saponin from Korean red ginseng(TSKRG) on thrombin-produced thromboxane $A_2$ ($TXA_2$), an aggregating thrombogenic molecule, and its associated microsomal enzymes cyclooxygenase (COX)-1 and $TXA_2$ synthase (TXAS). Thrombin (0.5 U/mL) increased $TXA_2$ production up to 169 ng/$10^8$ platelets as compared with control (0.2 ng/$10^8$ platelets). However, TSKRG inhibited potently $TXA_2$ production to the control level in a dose-dependent manner, which was associated with the strong inhibition of COX-1 and TXAS activities in platelet microsomes having cytochrome c reductase activity. The results demonstrate TSKRG is a beneficial traditional oriental medicine in platelet-mediated thrombotic diseases via suppression of COX-1 and TXAS to inhibit production of $TXA_2$.

Evaluation of failed implants and reimplantation at sites of previous dental implant failure: survival rates and risk factors

  • Park, Yu-Seon;Lee, Bo-Ah;Choi, Seong-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • v.52 no.3
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    • pp.230-241
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    • 2022
  • Purpose: The purpose of this study was to evaluate failed implants and reimplantation survival and to identify the relative risk factors for implant re-failure. Methods: Ninety-one dental implants were extracted between 2006 and 2020 at the National Health Insurance Service Ilsan Hospital, including 56 implants in the maxilla and 35 implants in the mandible that were removed from 77 patients. Patient information (e.g., age, sex, and systemic diseases) and surgical information (e.g., the date of surgery and location of the implants and bone grafts) were recorded. If an implant prosthesis was used, prosthesis information was also recorded. Results: In total, 91 first-time failed dental implants in 77 patients were analyzed. Of them, 69 implants in 61 patients received reimplantation after failure. Sixteen patients (22 implants) refused reimplantation or received reimplantation at a different site. Eight of the 69 reimplants failed again. The 1-year survival rate of the 69 reimplants was 89.4%. Age at reimplantation and smoking significantly increased the risk of reimplantation failure. However, a history of taking anti-thrombotic agents showed a statistically significant negative association with reimplantation failure. Of the failed implants, 66% showed early failure and 34% showed late failure of the initial implantation. All 8 re-failed implants showed early failure. Only 3 of these 8 failed reimplants were re-tried and the second reimplants all survived. Conclusions: The total survival rate of implants, which included reimplants and second reimplants was 99.2%, although the survival rate of the initial implantations was 96.3%. Previous failure did not affect the success of the next trial. Reimplantation failure was more strongly affected by patient factors than by implant factors. Therefore, each patient's specific factors need to be meticulously controlled to achieve successful reimplantation.

Effects of the ethanol extract of Codonopsis Pilosulae Radix on ovalbumin-induced allergic responses in mice (난알부민 유도 알레르기 면역반응에 대한 당삼(黨參)에탄올추출물의 효능 연구)

  • Kang, Seok Yong;Jung, Jin Ki;Lee, Sang Kook;Lee, Seung Ho;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.28 no.2
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    • pp.9-15
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    • 2013
  • Objectives : The root of Codonopsis pilosula (Fr.) Nannf. (Codonopsis Pilosulae Radix) has been traditionally used as a oriental medicine with an anti-thrombotic, antidiabetic, anticancer, and anti-gastric ulcer effects and immunological adjuvant. In this study, we investigated the effect of 70% ethanol extract of Codonopsis Pilosulae Radix (CPR-E) on ovalbumin (OVA)-induced allergic responses in mice. Methods : Mice were sensitized (1, 8, and 15 days) with OVA and airway challenged(22, 24, 26, 28, and 30 days) to induced allergic responses. CPR-E extract at doses of 50 and 100 mg/kg/body weight was orally administered from days 21 to 30 consecutively. The levels of allergic mediators such as histamine, OVA-specific immunoglobulin (Ig) E, and Th1/Th2 cytokines such as IFN-${\gamma}$ and IL-4 were measured in the sera of mice by ELISA. The histological change of lung tissue was observed by hematoxylin and eosin (H&E) staining. Results : CPR-E extract significantly decreased the serum levels of histamine, OVA-specific IgE, and IL-4 compared with those of OVA control group, but significantly increased the serum level of IFN-${\gamma}$. Based on H&E staining, CPR-E extract inhibited the infiltration of inflammatory cells into lung tissues with histological changes. Conclusions : These results indicate that CPR-E extract has anti-inflammatory and anti-allergic responses through regulating the cytokine balance, suggesting that the extract may be useful for the treatment of allergic inflammatory diseases such as bronchial asthma and allergic rhinitis.

Anti-thrombotic effects of ginsenoside Rk3 by regulating cAMP and PI3K/MAPK pathway on human platelets

  • Hyuk-Woo Kwon ;Jung-Hae Shin ;Man Hee Rhee ;Chang-Eun Park ;Dong-Ha Lee
    • Journal of Ginseng Research
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    • v.47 no.6
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    • pp.706-713
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    • 2023
  • Background and objective: The ability to inhibit aggregation has been demonstrated with synthetically derived ginsenoside compounds G-Rp (1, 3, and 4) and ginsenosides naturally found in Panax ginseng 20(S)-Rg3, Rg6, F4, and Ro. Among these compounds, Rk3 (G-Rk3) from Panax ginseng needs to be further explored in order to reveal the mechanisms of action during inhibition. Methodology: Our study focused to investigate the action of G-Rk3 on agonist-stimulated human platelet aggregation, inhibition of platelet signaling molecules such as fibrinogen binding with integrin αIIbβ3 using flow cytometry, intracellular calcium mobilization, dense granule secretion, and thromboxane B2 secretion. In addition, we checked the regulation of phosphorylation on PI3K/MAPK pathway, and thrombin-induced clot retraction was also observed in platelets rich plasma. Key Results: G-Rk3 significantly increased amounts of cyclic adenosine monophosphate (cAMP) and led to significant phosphorylation of cAMP-dependent kinase substrates vasodilator-stimulated phosphoprotein (VASP) and inositol 1,4,5-trisphosphate receptor (IP3R). In the presence of G-Rk3, dense tubular system Ca2+ was inhibited, and platelet activity was lowered by inactivating the integrin αIIb/β3 and reducing the binding of fibrinogen. Furthermore, the effect of G-Rk3 extended to the inhibition of MAPK and PI3K/Akt phosphorylation resulting in the reduced secretion of intracellular granules and reduced production of TXA2. Lastly, G-Rk3 inhibited platelet aggregation and thrombus formation via fibrin clot. Conclusions and implications: These results suggest that when dealing with cardiovascular diseases brought upon by faulty aggregation among platelets or through the formation of a thrombus, the G-Rk3 compound can play a role as an effective prophylactic or therapeutic agent.

Ref-1 protects against FeCl3-induced thrombosis and tissue factor expression via the GSK3β-NF-κB pathway

  • Lee, Ikjun;Nagar, Harsha;Kim, Seonhee;Choi, Su-jeong;Piao, Shuyu;Ahn, Moonsang;Jeon, Byeong Hwa;Oh, Sang-Ha;Kang, Shin Kwang;Kim, Cuk-Seong
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.1
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    • pp.59-68
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    • 2021
  • Arterial thrombosis and its associated diseases are considered to constitute a major healthcare problem. Arterial thrombosis, defined as blood clot formation in an artery that interrupts blood circulation, is associated with many cardiovascular diseases. Oxidative stress is one of many important factors that aggravates the pathophysiological process of arterial thrombosis. Apurinic/apyrimidinic endonuclease 1/redox factor-1 (Ref-1) has a multifunctional role in cells that includes the regulation of oxidative stress and anti-inflammatory function. The aim of this study was to investigate the therapeutic effect of adenovirus-mediated Ref-1 overexpression on arterial thrombosis induced by 60% FeCl3 solution in rats. Blood flow was measured to detect the time to occlusion, thrombus formation was detected by hematoxylin and eosin staining, reactive oxygen species (ROS) levels were detected by high-performance liquid chromatography, and the expression of tissue factor and other proteins was detected by Western blot. FeCl3 aggravated thrombus formation in carotid arteries and reduced the time to artery occlusion. Ref-1 significantly delayed arterial obstruction via the inhibition of thrombus formation, especially by downregulating tissue factor expression through the Akt-GSK3β-NF-κB signaling pathway. Ref1 also reduced the expression of vascular inflammation markers ICAM-1 and VCAM-1, and reduced the level of ROS that contributed to thrombus formation. The results showed that adenovirus-mediated Ref-1 overexpression reduced thrombus formation in the rat carotid artery. In summary, Ref-1 overexpression had anti-thrombotic effects in a carotid artery thrombosis model and could be a target for the treatment of arterial thrombosis.

Screening of Antioxidative, Anti-thrombotic and Anti-atherosclerotic Effects of Moutan Root Bark Extracts (Moutan Root Bark가 항산화활성과 LDL 산화 억제 및 항철소판 응접에 미치는 영향)

  • Ban, Chang-Kye;Lee, Min-Ja;Lee, Hye-Sook;Jung, Hyun-Jung;Kim, Hyuck;Kim, Jai-Eun;Park, Sun-Dong;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.135-143
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    • 2009
  • There is currently increased interest in the identification of antioxidant compounds that are pharmacologically potent and have low or no side effects. Plants produce significant amounts of antioxidants to prevent the oxidative stress caused by photons and oxygen, therefore they represent a potential source of new compounds with antioxidant activity. Moutan Root Sark (MRS) has been frequently used as analgesic. antispasmodic, anti-inflammatory and remedies for female diseases. In this study. the antioxidant activity of extract from MRS was studied in vitro methods by measuring the antioxidant activity by TEAC, measuring the scavenging effects on reactive oxygen species (ROS) [superoxide anion, hydroxyl radical] and on reactive nitrogen species (RNS) [nitric oxide and peroxynitrite] as well as measuring the inhibitory effect on $Cu^{2+}$ induced human LDL oxidation and the inhibitory effect on collagen induced platelet aggregation. The MRS extracts were found to have a potent scavenging activity, as well as an inhibitory effect on LDL oxidation and on platelet aggregation. In conclusion, the MRS extracts have anti-oxidative and anti-atherosclerotic effects in vitro system, which can be used for developing pharmaceutical drug against oxidative stress and atherosclerosis.

Aged Garlic Extract and Its Components Inhibit Platelet Aggregation in Rat (흰쥐에서 흑마늘 추출물과 그 성분들에 의한 혈소판 응집억제 효과)

  • Choi, You-Hee;Jeong, Hyung-Min;Kyung, Kyu-Hang;Ryu, Beung-Ho;Lee, Kwang-Youl
    • Journal of Life Science
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    • v.21 no.10
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    • pp.1355-1363
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    • 2011
  • Many clinical trials have demonstrated the beneficial effects of garlic (Allium sativum) on general cardiovascular health. Aged garlic extract (AGE) is known to display diverse biological activities such as in antioxidant, anti-inflammatory and anticancer activities. However, few studies have been directed on the effect of AGE on cardiovascular function. In this study, we aimed to investigate the effect of AGE and its components on platelet activation, a key contributor in thrombotic diseases. In freshly isolated rat platelets, AGE and its components have shown inhibitory activities on thrombin-induced platelet aggregation. These in vitro results were further confirmed in an in vivo platelet aggregation measurement where tail vein injection of garlic oil and S-Allylmercapto-cysteine (SAMC) significantly reduced thrombin and ADP-induced platelet aggregation. Potential active components for antiplatelet effects of AGE were identified to be SAMC and diallyl sulphide through agonist-induced platelet aggregation assay. These results indicate that aged garlic extract can be a novel dietary supplement for the prevention of cardiovascular risks and the improvement of blood circulation.