• Title/Summary/Keyword: anti-bleeding

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The Association of CHADS-P2A2RC Risk Score With Clinical Outcomes in Patients Taking P2Y12 Inhibitor Monotherapy After 3 Months of Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention

  • Pil Sang Song;Seok-Woo Seong;Ji-Yeon Kim;Soo Yeon An;Mi Joo Kim;Kye Taek Ahn;Seon-Ah Jin;Jin-Ok Jeong;Jeong Hoon Yang;Joo-Yong Hahn;Hyeon-Cheol Gwon;Woo Jin Jang;Hyuck Jun Yoon;Jang-Whan Bae;Woong Gil Choi;Young Bin Song
    • Korean Circulation Journal
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    • v.54 no.4
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    • pp.189-200
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    • 2024
  • Background and Objectives: Concerns remain that early aspirin cessation may be associated with potential harm in subsets at high risk of ischemic events. This study aimed to assess the effects of P2Y12 inhibitor monotherapy after 3-month dual antiplatelet therapy (DAPT) vs. prolonged DAPT (12-month or longer) based on the ischemic risk stratification, the CHADS-P2A2RC, after percutaneous coronary intervention (PCI). Methods: This was a sub-study of the SMART-CHOICE trial. The effect of the randomized antiplatelet strategies was assessed across 3 CHADS-P2A2RC risk score categories. The primary outcome was a major adverse cardiac and cerebral event (MACCE), a composite of all-cause death, myocardial infarction, or stroke. Results: Up to 3 years, the high CHADS-P2A2RC risk score group had the highest incidence of MACCE (105 [12.1%], adjusted hazard ratio [HR], 2.927; 95% confidence interval [CI], 1.358-6.309; p=0.006) followed by moderate-risk (40 [1.4%], adjusted HR, 1.786; 95% CI, 0.868-3.674; p=0.115) and low-risk (9 [0.5%], reference). In secondary analyses, P2Y12 inhibitor monotherapy reduced the Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding without increasing the risk of MACCE as compared with prolonged DAPT across the 3 CHADS-P2A2RC risk strata without significant interaction term (interaction p for MACCE=0.705 and interaction p for BARC types 2, 3, or 5 bleeding=0.055). Conclusions: The CHADS-P2A2RC risk score is valuable in discriminating high-ischemic-risk patients. Even in such patients with a high risk of ischemic events, P2Y12 inhibitor monotherapy was associated with a lower incidence of bleeding without increased risk of ischemic events compared with prolonged DAPT.

Inhibitory Effects of Galla Chinensis Extract on Cariogenic Properties of Streptococcus mutans (오배자 Galla Chinensis 추출물이 Streptococcus mutans의 우식활성 억제에 미치는 영향)

  • Park, Bog Im;Jung, Won Chang;You, Sung Jin;Lee, Chan Woo;Kim, Jung Sun;An, So Youn;Jeon, Byung Hun;You, Yong Ouk;Kim, Kang Ju
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.2
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    • pp.189-194
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    • 2015
  • Streptococcus mutans (S. mutans) is one of the most important bacteria in the formation of dental plaque and dental caries. S. mutans adheres to an acquired pellicle formed on the tooth surface, and aggregates with many oral bacteria, and initiates plaque formation by synthesizing glucan from sucrose, which is catalyzed by glucosyltransferases. S. mutans metabolizes the dietary sugar to the organic acids. The organic acids demineralize tooth surface and result in dental caries. Galla Chinensis have been traditionally used for stopping bleeding of gingiva, removing edema and halitosis, drainage, fixing the teeth and as an antiphlogistic agent. In previous reports, antibacterial effects of Galla Chinensis have been investigated whereas anti-cariogenic effects is still not examined enough. Therefore we tested effects of ethanol extracts of Galla Chinensis on the cariogenic properties such as the growth, acid production, adhesion, and insoluble glucan synthesis of S. mutans. In the result, ethanol extracts of Galla Chinensis showed the inhibition of S. mutans growth and organic acids production over 0.031 mg/ml concentrations. The adhesion of S. mutans to Saliva-coated Hydroxyapatite beads S-HAs has decreased with the increase of concentration of ethanol extracts of Galla Chinensis. And it seems to have adhesion inhibitory effect in concentration of over 0.25 mg/ml. It gives us the result that Galla Chinensis have anti-caries effects. But ethanol extract of Galla Chinensis didn't have inhibitory effect on insoluble glucan synthesis. Preliminary phytochemical analysis of the ethanol extract of Galla Chinensis showed strong phenolic compounds, medium steroids & terpenoids and glycosides, and weak organic acids and peptides. These results suggest that the ethanol extracts of Galla Chinensis may have anti-cariogenic properties, which may be able to be related with strong phenolic compounds.

Preventive Effect of the Water Extract of Agrimonia pilosa Ledeb and Micronucleus Assay-Based Evaluation of Genotoxicity in Gastritis Animal Models (동물모델을 이용한 짚신나물 물 추출물의 위염 예방효과 및 유전독성 평가)

  • Nho, Jong Hyun;Jang, Ji Hun;Lee, Hyun Joo;Yang, Beodul;Woo, Kyeong Wan;Kim, A Hyeon;Seo, Jae Wan;Hwang, Tae Yeon;Cho, Hyun Woo;Jung, Ho Kyung
    • Korean Journal of Medicinal Crop Science
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    • v.27 no.2
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    • pp.136-142
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    • 2019
  • Background: Agrimonia pilosa Ledeb has been used as a traditional medicine for the treatment of hematuresis and uterine bleeding in Korea. It has been reported to have anti-obesity, anti-diabetes and anti-inflammaotry effect by regulating the inflammatory signaling pathway. However, the preventive effect of Agrimonia pilosa Ledeb on gastritis has not been elucidated. Thus, in the present study, we evaluated the effects of the water extract of Agrimonia pilosa Ledeb (APW) using HCl/EtOH-induced gastritis rat models. Method and Results: Gastritis was induced in rats by HCl/EtOH administration. The rats in each group were orally administered with two doses of APW (100 and 500 mg/kg). Omeprazole was used as a positive control drug. An enzyme-linked immunosorbent assay (ELISA) was used to measure the prostaglandin $E_2$ ($PGE_2$) levels in stomach. The treatment with 500 mg/kg APW reduced the gastric ulcer area. The APW treatment prevented a decreased in $PGE_2$ concentration induced by HCl/EtOH in rats. In the micronucleus test, the ratio of micronucleated polychromatic erythrocytes to polychromatic erythrocytes showed no significant change in the APW-treated group compared with the control group. Conclusions: These results indicate that APW could be used to prevent the gastritis caused by the HCl/EtOH-induced damage to stomach lining. In addition, the APW treatment showed no significant change in results of the micronucleus test. However, further experiments are required to determine how APW influenced the secretion of mucus and gastric acid using the chromosome aberration test and bacterial reverse mutation assay.

Protective Effect of Water Extract of Leonurus japonicus Houttuyn against HCl/EtOH-induced Gastric Mucosal Damage and Genotoxicity Evaluation using Micronucleus Test (익모초 물 추출물의 위염 예방효과 및 소핵시험을 이용한 유전독성 평가)

  • Nho, Jong Hyun;Lee, Hyun Joo;Jang, Ji Hun;Yang, Beo Dul;Woo, Kyeong Wan;Kim, A Hyeon;Seo, Jae Wan;Kim, Sun Young;Cho, Hyun Woo;Jung, Ho Kyung
    • Korean Journal of Plant Resources
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    • v.32 no.4
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    • pp.282-289
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    • 2019
  • Gastritis is an inflammatory disease involving the stomach and is caused by several factors, including stress, non-steroidal anti-inflammatory drugs such as aspirin, liquor, and Helicobacter pylori. In Korea, Leonurus japonicus Houttuyn (LJW) has been used as traditional medicine for vaginal bleeding, hematuria, and bruise. Previous studies have reported that LJW exhibited hepatoprotective, cardioprotective, and anti-hyperlipidemic effect. However, the effect of the water extract of LJW on gastritis was not elucidated. Thus, we evaluated the anti-gastric effect and genotoxicity of LJW. LJW effectively prevented the degeneration of surface mucous cells and glandular epithelial cells and vascular congestion induced by HCl/EtOH. Micronucleus assay indicated that the rate of micronucleated polychromatic erythrocytes/polychromatic erythrocytes was not significantly different compared that of the control. Further experiments are required to determine the role of LJW in the gastric injury process such as cyclooxygenase signaling pathway and the secretion of mucus in the stomach.

Antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol (자몽종자추출물과 자일리톨이 배합된 껌의 치은염 예방 및 항균효과)

  • Jin, Mi-Sung;Yoo, Yun-Jung;Choi, Bong-Kyu;Lee, Hee-Young;Kim, Mi-Jung;Roh, Hoe-Jin;Park, Jong-Sub;Cho, Kyoo-Sung;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.33 no.3
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    • pp.485-497
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    • 2003
  • Grapefruit seed extract has been reported to have antimicrobial effect. The purpose of this study was to evaluate the antimicrobial and anti-gingivitis effect of chewing gum containing grapefruit seed extract and xylitol. 40 healthy subjects with gingivitis or early periodontitis were divided into two groups. Subjects in the experimental group chewed gum containing grapefruit seed extract and xylitol while subjects in the control group chewed gum containing only xylitol. All subjects received scaling and tooth brushing instruction. 1 week after scaling was set as baseline. Gingival index and plaque index were scored at baseline, 1 week, 2 week, 3 week and 4 week. Bleeding index, probing pocket depth and clinical attachment level were scored at baseline, 2 week and 4 week. The number of total bacteria and Streptococcus mutans in unstimulated saliva of experimental group were counted at 1 week, 2 week, 3 week and 4 week. Gingival indices of experimental group and control group at baseline, 1 week, 2 week, 3 week and 4 week were 0.850${\pm}$0.298, 0.575${\pm}$0.345, 0.533${\pm}$0.332, 0.459${\pm}$0.311, 0.408${\pm}$0.224 and 0.758${\pm}$0.379, 0.592${\pm}$0.276, 0.563${\pm}$0.281, 0.454${\pm}$0.194, 0.413${\pm}$0.199 (mean${\pm}$SD), respectively. Plaque indices of experimental group and control group at baseline, 1 week. 2 week, 3 week and 4 week were 0.497${\pm}$0.500, 0.375${\pm}$0.484, 0.332${\pm}$0.471, 0,286${\pm}$0.452, 0.210${\pm}$0.407 and 0.411${\pm}$0.492, 0.375${\pm}$0.484, 0.354${\pm}$0.479, 0.313${\pm}$0.463, 0.193${\pm}$0.395, respectively. Bleeding indices of experimental group and control group at baseline, 2 week and 4 week were 0.377${\pm}$0.177, 0.298${\pm}$0.152, 0.192${\pm}$0.108 and 0.383${\pm}$0.124, 0.318${\pm}$0.153, 0.225${\pm}$0.126, respectively. Probing pocket depth of experimental group and control group at baseline, 2 week and 4 week were 2.56${\pm}$1.00, 2.40${\pm}$0.65, 2.23${\pm}$0.64 and 2.45${\pm}$0.682.37${\pm}$0.57, 2.19${\pm}$0.57, respectively. Clinical attachment level of experimental group and control group at baseline, 2 week and 4 week were 2.58${\pm}$1.01, 2.43${\pm}$0.67, 2.26${\pm}$0.65 and 2.49${\pm}$0.70, 2.40${\pm}$0.59, 2.22${\pm}$0.62, respectively. The % of reduction of total bacteria in saliva of experimental group at 2 week, 3 week and 4 week were 46 ${\pm}$ 53%, 53 ${\pm}$ 5% and 69 ${\pm}$ 33%. The % of reduction of Streptococcus mutans count in saliva of experimental group at 2 week, 3 week and 4 week were 52${\pm}$69%, 88${\pm}$30% and 89${\pm}$17%. From these findings, it can be concluded that regular use of grapefruit seed extract /xylitol chewing gum may be effective to control and prevent gingivitis and may have caries-preventive effect.

Study on Material Segregation of Grout and Filling Characteristic of Grouting for Post-Tensioned Concrete Beam (PC 그라우트의 재료분리 및 PC 빔 그라우팅 충전성에 관한 연구)

  • Lee, Jun-Ki;Choi, Joon-Ho;Yoon, Jeong-Seob;Cho, In-Sung
    • Journal of the Korea Concrete Institute
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    • v.22 no.3
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    • pp.419-426
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    • 2010
  • This paper discusses a series of experiments including material improvement in order to ensure quality of grouting for the post-tensioned structure. In presstressed concrete, grouting refers to the construction procedure of filling empty space of duct enclosing the prestress tendons using cementitious material, To date, adequate quality control of the grouting has not been established in Korea because the relationship between the grouting and durability of post-tensioned structure is not well-recognized. The Korean standard does not consider the important material characteristic, wick effect, which is caused by tendons in the ducts, and furthermore current standard testing method does not quantify reasonable material segregation. As a result, the grout material, which satisfies the current material standards, may well exhibit excessive bleeding of water or shrinkage during construction. In this study, international codes and standards related to grouting were surveyed. The mix proportions of the constituents and novel admixtures were suggested to meet equivalently with these standards. Performance of this enhanced grout was compared with common domestic grouts using the international standard testing method. A series of mock-up specimens considering geometry of PC beam was constructed and grout flow pattern was observed as the grout was injected. It was observed that the grouting performance was highly influenced by material properties and filling characteristic can be varied depending on geometry of ducts.

Stabilization of Covalently Cross-Linked SPEEK/Cs-Substituted HPA Composite Membranes for Water Electrolysis ($Cs^+$치환에 따른 수전해용 공유가교 SPEEK/HPA 복합막의 안정화)

  • Jee, Bong-Chul;Ha, Sung-In;Song, Min-Ah;Chung, Jang-Hoon;Moon, Sang-Bong;Kang, An-Soo
    • Transactions of the Korean hydrogen and new energy society
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    • v.22 no.1
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    • pp.1-12
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    • 2011
  • To improve the mechanical properties, such as durabilities and antioxidative characteristics, the covalently cross-linked (CL-) SPEEK (sulfonated polyether ether ketone)/Cs-substituted HPA (heteropoly acid) organic-inorganic composite membranes (CL-SPEEK/Cs-HPAs), have been intensively investigated. The composite membrane were prepared by blending cesium-substituted HPAs (Cs-HPAs), including tungstophosphoric acid (TPA), molybdophosphoric acid (MoPA), and tungstosilicic acid (TSiA) with cross-linking agent content of 0.01 mL. And composite electrolytes composed of Cs-HPAs, prepared by immersion (imm.) and titration (titr.) methods to increase the stability of HPAs in water, were applied to polymer electrolyte membrane electrolysis (PEME). As a result, the proton conductivity of Cs-substituted composite membranes increased rapidly over $60^{\circ}C$ but mechanical properties, such as tensile strength, decreased in accordance with added Cs content. The bleeding-out of Cs-TPA membranes by titration method (50 vol.% Cs) decreased steadily to 2.15%. In the oxidative stability test by Fenton solution, the durability of membranes with Cs-HPA significantly increased. In case of CL-SPEEK/ Cs-TPA membrane, duration time increased more than 1200 hours. It is expected that even though CL-SPEEK/Cs-MoPA membrane shows the high proton conductivity, electrocatalytic activity and cell voltage of 1.80 V for water electrolysis, the CL-SPEEK/Cs-TPA (imm.) is more suitable as an alternative membrane in real system with the satisfactory proton conductivity, mechanical properties, anti-oxidative stability and cell voltage of 1.89 V.

Effect of Gargle Containing Citrex and Cetylpyridinium Chloride on the Oral Pathogenic Bacteria (수종약물성분이 함유된 양치액의 구강질환 유발균 및 구강환경에 미치는 영향에 관한 연구)

  • Park, Young-Min;Lee, Eun-Suk
    • Journal of dental hygiene science
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    • v.2 no.1
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    • pp.11-14
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    • 2002
  • The purpose of this study was to investigate that the effect of Citrex and CPC on the growth of oral microorganism such as Streptococcus mutans KCTC 3065, Candida albicans KCTC 7122, and Staphylococcus aureus KCTC 1916 which were cariogenic, candidiasis(bleeding gum, dry mouth and tongue, thrush) and angular cheilitis inducing bacteria, respectively. The efficacy of complex of Citrex and CPC was determined in assays measuring Halo Test. The gargle containing Citrex(0.02%) and CPC(0.02%) demonstrated broad-spectrum anti-microbial properties, with activity against both Gram-positive and Gram-negative and a yeast(Candida albicans).

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Validation of Nafamostat Mesilate as an Anticoagulant in Extracorporeal Membrane Oxygenation: A Large-Animal Experiment

  • Han, Sung Joon;Han, Woosik;Song, Hee-Jung;Kim, Cuk-Seong;Jeong, Seong-Mok;Kang, Min Woong
    • Journal of Chest Surgery
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    • v.51 no.2
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    • pp.114-121
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    • 2018
  • Background: Unfractionated heparin is commonly used for anticoagulation in extracorporeal membrane oxygenation (ECMO). Several studies have shown that nafamostat mesilate (NM) has comparable clinical outcomes to unfractionated heparin. This study compared anticoagulation with NM and heparin in a large-animal model. Methods: Beagle dogs (n=8; weight, 6.5-9 kg) were placed on venovenous ECMO. Blood samples were taken every hour and the following parameters were compared: hemoglobin level, activated partial thromboplastin time (aPTT), thromboelastography (TEG) data, platelet function, and inflammatory cytokine levels. Results: In both groups, the aPTT was longer than the baseline value. Although the aPTT in the NM group was shorter than in the heparin group, the TEG parameters were similar between the 2 groups. Hemoglobin levels decreased in both groups, but the decrease was less with NM than with heparin (p=0.049). Interleukin $(IL)-1{\beta}$ levels significantly decreased in the NM group (p=0.01), but there was no difference in the levels of tumor necrosis factor alpha or IL-10 between the 2 groups. Conclusion: NM showed a similar anticoagulant effect to that of unfractionated heparin, with fewer bleeding complications. NM also had anti-inflammatory properties during ECMO. Based on this preclinical study, NM may be a good alternative candidate for anticoagulation in ECMO.

Clinical Analysis of Cardiac Valve Surgery (심장판막증의 외과적 치료)

  • 김형묵
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.446-455
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    • 1985
  • A total and consecutive 156 patients have undergone cardiac valve surgery including 13 closed mitral commissurotomy, 13 open mitral commissurotomy, one mitral annuloplasty, 75 mitral valve replacement, one aortic annuloplasty, 24 aortic valve replacement, 3 tricuspid valve replacement, 25 double valve replacement and one triple valve replacement. 155 prosthetic valves were replaced in a period between September 1976 and August 1985. There were 68 males and 88 females with age range from 8 to 69 yrs [mean 36.5 yr]. Out of replaced valves, 61 was tissue valve including 54 Carpentier-Edwards, and 4 was mechanical valves including 74 St. Jude Medical, and the position replaced was 101 valves for mitral, 46 for aortic and 8 for tricuspid. Single valve replacement in 102 cases, double valve replacement in 25 cases [17 for AVR+MVR, and 8 for MVR+TVR], and only one case was noted in the triple valve replacement. Early mortality within 30 days after operation was noted in 11 cases [7%]; 7 after MVR, 2 after DVR, and each one after open mitral commissurotomy and mitral annuloplasty. Cause of death was valve thrombus, cerebral air embolism, low output syndrome, uncontrollable arrhythmia, parapneumonic sepsis, acute cardiac tamponade and left atrial rupture. 7 late deaths were noted during the follow-up period from 1 to 104 months [average 48 month]; three due to valve and left atrial thrombus formation, two due to CVA from overdose of warfarin, and each one due to congestive heart failure and chronic constrictive pericarditis, Anticoagulants after prosthetic valve replacement were maintained with warfarin, dipyridamole and aspirin to the level of around 50% of normal prothrombin time in 79 cases, and Ticlopidine with aspirin in 47 cases to compare the result of each group. There were 11 major thromboembolic episodes including 3 deaths in the warfarin group. Two cases of CVA due to overdose of warfarin was noted in the warfarin group. In the ticlopidine group, there was only one left atrial thrombus confirmed at the time of autopsy. Among the survived 138 cases, nearly all cases[136 cases] were included in NYHA functional class I and II during the follow-up period. In conclusion, surgical treatment of the cardiac valve disease in 156 clinical cases revealed excellent result with acceptable operative risk and late mortality. Prevention of thrombus formation with anti-platelet aggregator Ticlopidine has better result than warfarin group presently with no specific side effect such as bleeding or gastrointestinal trouble.

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