• Clinical Endoscopy
• /
• 제57권2호
• /
• pp.141-157
• /
• 2024

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

• International Journal of Heart Failure
• /
• 제6권1호
• /
• pp.36-43
• /
• 2024

Background and Objectives: Atrial fibrillation is common in patients with cardiac amyloidosis. However, the optimal anticoagulation strategy to prevent thromboembolic events in patients with cardiac amyloidosis and atrial fibrillation is unknown. This systematic review and meta-analysis compares direct oral anticoagulants (DOACs) vs. vitamin K antagonists (VKAs) in patients with cardiac amyloidosis and atrial fibrillation. Methods: We performed a systematic literature review to identify clinical studies of anticoagulation therapies for patients with cardiac amyloidosis and atrial fibrillation. The primary outcomes of major bleeding and thrombotic events were reported using random effects risk ratios (RRs) with 95% confidence interval (CI). Results: Our search yielded 97 potential studies and evaluated 14 full-text articles based on title and abstract. We excluded 10 studies that were review articles or did not compare anticoagulation. We included 4 studies reporting on 1,579 patients. The pooled estimates are likely underpowered due to small sample sizes. There was no difference in bleeding events for patients with cardiac amyloidosis and atrial fibrillation treated with DOACs compared to VKAs with a RR of 0.64 (95% CI, 0.38-1.10; p=0.10). There were decreased thrombotic events for patients with cardiac amyloidosis and atrial fibrillation treated with DOACs compared to VKAs with a RR of 0.50 (95% CI, 0.32-0.79; p=0.003). Conclusions: This systematic review and meta-analysis suggests that DOACs are as safe and effective as VKAs in patients with cardiac amyloidosis and atrial fibrillation. However, more data are needed to investigate clinical differences in anticoagulation therapy in this patient population.

• Journal of Mechanical Science and Technology
• /
• 제16권12호
• /
• pp.1719-1724
• /
• 2002

A previously designed capillary viscometer with measuring differential pressure was modified to measure the viscosity of non-Newtonian fluids including unadulterated blood continuously over numerous shear rates in a single measurement. Because of unavoidable experimental noise and a limited number of data, the previous capillary viscometer experienced an inaccuracy and could not directly determine a viscosity without an iterative calculation. However, in the present measurement there are numerous data available near the point of interest so that the numeric value of the derivative, d(In Q)/d(In Q$\sub$w/), is no longer sensitive to the method of differentiation. In addition, relatively low and wide shear rate viscosity measurements were possible because of the present precision pressure-scanning method with respect to time. For aqueous polymer solutions, excellent agreement was found between the results from the pressure-scanning capillary viscometer and those from a commercially available rotating viscometer. In addition, the pressure-scanning capillary viscometer measured the viscosity of unadulterated whole blood without adding any anticoagulants.

• 셀메드
• /
• 제4권3호
• /
• pp.17.1-17.8
• /
• 2014

Herbal remedies are commonly used by patients worldwide. Because these herbal preparations share the same metabolic and transport proteins with prescribed medicines, the potential for a drug-herb interaction is substantial and is an issue of significant concern. This review paper summarizes drug-herb interactions involving inhibition or induction of cytochrome P450 enzymes, drug transporters as well as modulation of drug pharmacodynamics. An increasing number of in vitro and animal studies, case reports and clinical trials evaluating such interactions have been reported, and implications of these studies are discussed in this review. The most commonly implicated drugs in the interaction include anticoagulants, antiplatelets, immunosuppressants, anti-neoplastics, protease inhibitors, and some antidepressants. Pharmacokinetic and/or pharmacodynamic interactions of five commonly used herbal remedies (danshen, garlic, Ginkgo biloba, ginseng, and St John's wort) with these drugs are presented, with focus of discussion being the potentials for interaction, their mechanisms and clinical implications. There is a necessity for adequate pharmacovigilance to be carried out in minimizing unanticipated but often preventable drug-herb interactions.

• Journal of Korean Neurosurgical Society
• /
• 제40권1호
• /
• pp.28-30
• /
• 2006

Two patients presented with amaurosis fugax[AMF]. despite treatment with antiplatelet drugs and anticoagulants due to previous transient ischemic attacks. Angiography demonstrated severe stenosis in the cavernous and petrous internal carotid artery[ICA] respectively, with reduced flow in the ophthalmic artery[OA]. Endovascular stent placement in both patients resulted in normalization of the vessel lumen of the stenotic vessel segments. In addition, complete restoration of OA flow was noted immediately after stenting. Both patients showed no further episode of AMF over a follow-up period of 38 and 23 months respectively. Our clinical and angiographic findings suggest that hemodynamic Insufficiency in retinal vasculature caused by a stenosis of the cavernous or petrous ICA can be treated successfully by endovascular stent.

• Neonatal Medicine
• /
• 제18권1호
• /
• pp.1-5
• /
• 2011

Coagulation involves the regulated sequence of proteolytic activation of a series of proteins to achieve appropriate and timely hemostasis in an injured vessel. In the non-pathological state, the inciting event involves exposure of circulating factor VIIa to extravascularly expressed tissue factor, which brings into motion the series of steps which results in cell based model of coagulation. In the new concepts of coagulation system, initiation, amplification and propagation steps are involved to converse of fibrinogen to fibrin. The precisely synchronized cascade of events is counter-balanced by a system of anticoagulant mechanisms. Developmental hemostasis refers to the age-related changes in the coagulation system that are most marked during neonate and childhood. An understanding of these changes in crucial to the accurate diagnosis of hemostatic abnormalities in neonate and children. This review aims to elucidate the main events within the coagulation cascade as it is currently understood to operate in vivo, and also a short review of the anticoagulants as they relate to this model. Also this paper describes the common pitfalls observed in the clinical data related to the coagulation system in neonate to children.

• 한국막학회:학술대회논문집
• /
• 한국막학회 1995년도 춘계 총회 및 학술발표회
• /
• pp.46-47
• /
• 1995

Chitosan, an unbranched (1-4)-linked-2-amino-2-deoxy-$\beta$-D-glucan, is prepared by chemical N-deacetylation of chitin, which is the main structure element of the cuticles of crab, shrimp, and insects, and is found in the cell walls of bacteria. It has the same main chain in its molecule like that of natural heparin. Heparin, an anionic polysaccharide, is the best of anticoagulants that have been found so far. In this study, to improve the blood compatibility of chitosan, 2-(methacrylovloxy)-ethyl-2-(trimethylammonium)ethyl phosphate(MTP) with phospholipid polar groups was grafted on the chitosan membranes and the biochemical properties the MTP-grafted chitosan membranes were investigated.

• The Korean Journal of Pain
• /
• 제27권3호
• /
• pp.294-296
• /
• 2014

Burning Mouth Syndrome (BMS) is defined as a chronic orofacial pain syndrome, without evidence of mucosal lesions and other clinical signs of disease or laboratory abnormalities. Patients with BMS complain of burning pain in the mouth, xerostomia and taste disturbances. It is more common among women and the median age of occurrence is about 60 years. BMS may be primary or secondary to other diseases. The mainstay in the treatment of BMS includes antidepressants, benzodiazepines, and anticonvulsants. A few cases of BMS caused due to medication have been reported. The causative drugs include angiotensin-converting enzyme inhibitors, anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines. This is a case report of a patient on antidepressants who developed symptoms of BMS thereby causing a dilemma in management.

• Bulletin of the Korean Chemical Society
• /
• 제32권1호
• /
• pp.65-70
• /
• 2011

Coumarins are ubiquitous in plant kingdom and have been used as antitumor, antifungals, anticoagulants, insecticides. Chalcones are also widespread in plant kingdom and have been known to possess diverse biological activities; antibacterial, antifungal, antitumor and anti-inflammatory, etc. As they are considered as important natural products, numerous synthetic approaches have been reported up to the present. We devise a new selective method of preparing dihydrocoumarins and chalcones from aryl cinnamates by the selection of reagents. Dihydrocoumarin derivatives were prepared selectively by using intramolecular cyclization catalyzed by p-toluene sulfonic acid. Also, chalcones were prepared by Fries-rearrangement catalyzed by $TiCl_4$. This method can be used for preparing various coumarin & chalcone compounds.

• Pediatric Infection and Vaccine
• /
• 제16권1호
• /
• pp.87-91
• /
• 2009

세균성 근염은 화농성 관절염, 봉와직염, 골수염, 혈전 정맥염, 다발성 근염, 혈종, 좌상, 종양과 감별이 필요하며 진단에 MRI가 도움이 된다. 저자들은 A군 사슬알균에 의한 화농성 근염을 조기에 진단하여 clindamycin으로 치료하였고 심부정맥 혈전증까지 합병되었던 환자를 경험하였다. 성인에서는 증례로 보고된 바가 있지만 국내에서는 아직 보고가 없어 이를 보고하는 바이다.