• 제목/요약/키워드: hemostasis

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Genetic classification and confirmation of inherited platelet disorders: current status in Korea

  • Shim, Ye Jee
    • Clinical and Experimental Pediatrics
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    • 제63권3호
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    • pp.79-87
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    • 2020
  • Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual processes involved in platelet production and hemostasis are genetically controlled; to date, mutations of more than 50 genes involved in various platelet biogenesis steps have been implicated in IPDs. Representative IPDs resulting from defects in specific pathways, such as thrombopoietin/MPL signaling; transcriptional regulation; granule formation, trafficking, and secretion; proplatelet formation; cytoskeleton regulation; and transmembrane glycoprotein signaling are reviewed, and the underlying gene mutations are discussed based on the National Center for Biotechnology Information database and Online Mendelian Inheritance in Man accession number. Further, the status and prevalence of genetically confirmed IPDs in Korea are explored based on searches of the PubMed and KoreaMed databases. IPDs are congenital bleeding disorders that can be dangerous due to unexpected bleeding and require genetic counseling for family members and descendants. Therefore, the pediatrician should be suspicious and aware of IPDs and perform the appropriate tests if the patient has unexpected bleeding. However, all IPDs are extremely rare; thus, the domestic incidences of IPDs are unclear and their diagnosis is difficult. Diagnostic confirmation or differential diagnoses of IPDs are challenging, time-consuming, and expensive, and patients are frequently misdiagnosed. Comprehensive molecular characterization and classification of these disorders should enable accurate and precise diagnosis and facilitate improved patient management.

풍(風)의 병리적(病理的) 의미규명(意味糾明)과 중풍(中風)의 원인(原因) 및 치료(治療)에 대한 동서의학적(東西醫學的) 비교(比較). (The study of comparison of Eastern-Western Medicine on the pathological concept of the Pung(風) and the cause and therapy of Jung Pung(中風) showed the following results.)

  • 김세길
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.96-117
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    • 1995
  • 1. The Pung(風) is the necessary power for growth and maintenance of life. 2. The characteristics of the Pung(風) is the Yang evil, the features for opening and excretion, mobility and rapid change. That is the major cause of all diseases, and its mobility is the main character. 3. Jung Pung(中風) is the same concept of apoplexy in Western medicine. 4. Jung Pung(中風) is classified on the basis of pathology, anatomy, and histology in Western Medicine, but In Oriental Medicine that is classified on the basis of symptom and severity of disease. 5. In Western Medicine, Jung Pung(中風) was regarded as the local cause of disease, but in Oriental Medicine regarded as the physiological changes caused by the weakness of the whole body. 6. In the emergency care, the method of GaeKeum is compared to Levin tubing, the method of to the use of urokinase for the promotion of cerebrovascular circulatio, and the method of To(吐法) to suction for the elimination of Dam(痰), the method of Hun(熏法) to the use of solution for the improvement of circulation. 7. With the comparison of the cause and diagnosis, the hemorrhagic disease and infarction were regarded as the major agents in Western Medicine and the symptom appeared in the patient was the standard of diagnosis and therapy in Oriental Medicine. 8. In the Western therapy of cerebral hemorrhage, the method of coagulation and hemostasis was used for the elimination of hematoma and cerebral edema, but in Oriental Medicine, the method of YanghaelGiHael(凉血止血) was used for descending the PungHwa(風火) and hemostasis. 9. In the period of recovering injury, the physical therapy was underlined for the recovering of partial function in Western Medicine, the method of accupuncture and drug therapy was adapted for the normal function of the whole body.

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Skoog씨 변법을 이용한 액취증의 치료 (The Treatment of Osmidrosis Axillae by Use of Modified Skoog's Method)

  • 임영민;최종우;김기호
    • Archives of Plastic Surgery
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    • 제32권2호
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    • pp.245-249
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    • 2005
  • Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

Disorder of Endothelia Vessels' Functional State with Malignant Tumors in Patients Exposed Anthropogenic Radiation

  • Pak, Laura;Noso, Yoshihiro;Chaizhunusova, Nailya;Manambaeva, Zukhra;Adylkhanov, Tasbolat;Takeichi, Nobuo;Olzhaev, Sayakhat;Aldyngurov, Daniyar;Tuleutayeva, Raikhan;Argynbekova, Ainur;Tanysheva, Gulyash;Zhazykbayeva, Lashyn;Baissalbayeva, Ainur;Rakhypbekov, Tolebay
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.575-579
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    • 2016
  • The aim of this research is to determine the characteristics of endothelial factors and the hemostatic system conditions with malignant neoplasms patients, which were exposed to ionizing radiation. Total number of examined people is 223, 153 of them are patients with gastrointestinal tract oncopathology. The article presents the results of the analysis of numerical indicators of endothelial condition and platelet hemostasis of patients, who had cancer. They lived in the regions of Kazakhstan, subjected to contamination of radionuclides as a result of nuclear weapons tests, which took place in this region from 1949 to 1989. These results then were compared to cancer patients and healthy individuals with no radiation risk. The study revealed the presence of higher levels of endothelial dysfunction and following trigger of the hemostatic system in patients with malignant tumors of the gastrointestinal tract. In particular, the defined high degree of endothelial dysfunction include endothelium-dependent vasodilation, content desquamated endothelial cells in peripheral blood and von Willebrand factor. These indicators have a clear correlation with the degree of disorder of studied parameters of the hemostasis, which can cause the development of thrombotic complications.

구강병소에 대한 펄스형 Nd: YAG 레이저의 치료효과 (The Therapeutic Effects of a Pulsed Nd:YAG Laser on Oral Lesions)

  • 신금백
    • Journal of Oral Medicine and Pain
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    • 제22권2호
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    • pp.309-325
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    • 1997
  • In order to set the lasing variables and evaluate, clinically, the therapeutic effects of a pulsed Nd:YAG laser on oral lesion, the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (wavelength 1064nm, Pulse duration 120$\mu$sec, fiber diameter 200$\mu$m/320$\mu$m) to 22 cases of oral soft tissue lesions and 6 cases of oral hard tissue lesions. The obtained results were as follows : 1. The effective excision with contact mode and the effective hemostasis of accompanied bleeding with noncontact mode were occurred by lasing on oral soft tissue lesions with fiber diameter of 320$\mu$m under the variables of 2.0~4.0W and 20~50Hz which were controlled into high power/low pulses for excision, low power/high pulses for hemostasis, low power in granulation tissue and high power in fibrous tissue according to therapeutic goals and tissue conditions. 2. About 50% of decreasing effect on hypersensitivity was occurred by lasing with non-contact and contact mode on cervical abrasion which caused dentinal hypersensitivity with fiber diameter of 320$\mu$m under the variables of 0.7 - 1.0W and 10Hz which were applied 2~3 times with 1 week interval. 3. The effective sterilization of infected root canal and lesion of periapical abscess was occurred by lasing with contact and spiral modes on wall of root canal and periapical abscess with fiber diameter of 200$\mu$m of which the tip was placed about 1mm shorter than root canal length under the variables of 1.OW and 10Hz.

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Electrosurgery를 이용한 치료증례 (ELECTROSURGERY IN DENTAL PRACTICE-A CASE REPORT)

  • 윤재웅;이상훈;이광수;한세현
    • 대한소아치과학회지
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    • 제23권3호
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    • pp.631-639
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    • 1996
  • Electrosurgical technique have been used in dentistry as an aid to soft tissue management for nearly 60 years. However, it was not until the late 1960s that the principles of electrosurgery were understood and improved equipment became available. Electrosurgery is a surgical procedure performed on soft tissue utilizing controlled high frequency electricaI(radio-frequency) currents in the range of 1,500,000 to 7,500,000 cyclesper second. The radio-frequency energy used in electrosurgery is able to cut and coagulate tissue because it focuses the energy at the small, active electrode. Advantages of electrosurgery for soft-tissue management during dental procedures include improved hemostasis, ease of tissue modification, improved visibility and so on, but adverse healing responses-including necrosis of soft tissue and sequestration of alveolar bone-have been reported. The present report provides examples of treatment of soft tissue and pulp tissue of primary teeth by electrosurgery. The results are as follows; 1. Electrosurgical techniques can be used for various procedures in pedodontics. 2. Electrosurgical procedures provide improved hemostasis and visibility in the operating field, which enable to remove, reshape, and contour soft tissues easily. 3. In pulpotomy technique, it was difficult to expect the variable pulpal response based on the degree of heat accumulation and the conditions of pulp tissues. Therefore, electrosurgical pulpotomy could not be considered as a method superior to formocresol pulpotomy. 4. A greater degree of dexterity and experiences in manipulation of the electrode is required compared with the conventional scalpel surgery.

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백서 두개골 결손부의 골재생에 fibrin glue가 미치는 영향에 관한 실험적 연구 (THE EXPERIMENTAL STUDY FOR INFLUENCE OF FIBRIN GLUE DURING HEALING PHASE AFTER MAKING ARTIFICIAL BONE DEFECT)

  • 임재석;장현석;윤정주;이의석;박은용;서제덕
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권5호
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    • pp.431-437
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    • 2005
  • Fibrin glue is composed of fibrinogen and thrombin and used in various regions for multiple use. Basic principle is that thrombin converts fibrinogen to fibrin in the presence of $Ca^{2+}$. The structure of fibrin is loose at the beginning, but after about 5 minutes a tight structure is formed under the influence of factor VIII which changes fibrin monomer into fibrin polymer. Fibrin glue is used for tissue adhesive, suture, local hemostasis, wound healing, closure of subdural space. Fibrin adhesive has been used in oral and maxillofacial surgery for hemostasis after tooth extraction in patients with coagulation disorders, skin graft fixation, reattachment of periodontal flaps, in combination with autogenous bone chips to fill the bony cavities following cyst removal, and for securing the hydroxyapatite granules for maxillary alveolar ridge augmentation. This study was designed for researching influence of fibrin glue during healing phase after making artificial bone defect.

Chemical and bioactive comparison of Panax notoginseng root and rhizome in raw and steamed forms

  • Xiong, Yin;Chen, Lijuan;Man, Jinhui;Hu, Yupiao;Cui, Xiuming
    • Journal of Ginseng Research
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    • 제43권3호
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    • pp.385-393
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    • 2019
  • Background: The root and rhizome are historically and officially utilized medicinal parts of Panax notoginseng (PN) (Burk.) F. H. Chen, which in raw and steamed forms are used differently in practice. Methods: To investigate the differences in chemical composition and bioactivities of PN root and rhizome between raw and steamed forms, high-performance liquid chromatography analyses and pharmacologic effects evaluated by tests of anticoagulation, antioxidation, hemostasis, antiinflammation, and hematopoiesis were combined. Results: With the duration of steaming time, the contents of ginsenosides $Rg_1$, Re, $Rb_1$, Rd, and notoginsenoside $R_1$ in PN were decreased, while those of ginsenosides $Rh_1$, $20(S)-Rg_3$, $20(R)-Rg_3$, $Rh_4$, and $Rk_3$ were increased gradually. Raw PN samples steamed for 6 h at $120^{\circ}C$ with stable levels of most constituents were used for the subsequent study of bioeffects. Raw PN showed better hemostasis, anticoagulation, and antiinflammation effects, while steamed PN exhibited stronger antioxidation and hematopoiesis activities. For different parts of PN, contents of saponins in PN rhizome were generally higher than those in the root, which could be related to the stronger bioactivities of rhizome compared with the same form of PN root. Conclusion: This study provides basic information about the chemical and bioactive comparison of PN root and rhizome in both raw and steamed forms, indicating that the change of saponins may have a key role in different properties of raw and steamed PN.

Comparative antiplatelet and antithrombotic effects of red ginseng and fermented red ginseng extracts

  • Irfan, Muhammad;Lee, Yuan Yee;Lee, Ki-Ja;Kim, Sung Dae;Rhee, Man Hee
    • Journal of Ginseng Research
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    • 제46권3호
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    • pp.387-395
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    • 2022
  • Background: Fermentation may alter the bioavailability of certain compounds, which may affect their efficacy and pharmacological responses. This study investigated the antiplatelet effects of red ginseng extract (RGE) and fermented red ginseng extract (FRG). Methods: A rodent model was used to evaluate the antiplatelet and antithrombotic effects of the extracts. Rats were orally fed with human equivalent doses of the extracts for 1 week and examined for various signaling pathways using standard in vivo and ex vivo techniques. Light transmission aggregometry was performed, and calcium mobilization, dense granule secretion, integrin αIIbβ3-mediated signaling molecules, cyclic nucleotide signaling events, and various protein molecules were evaluated ex vivo in collagen-stimulated washed platelets. Furthermore, antithrombotic properties were evaluated using a standard acute pulmonary thromboembolism model, and the effects on hemostasis were investigated using rat and mice models. Results: Both RGE and FRG significantly inhibited platelet aggregation, calcium mobilization, and dense granule secretion along with integrin-mediated fibrinogen binding and fibrinogen adhesion. cAMP levels were found to be elevated in RGE-treated rat platelets. Ginseng extracts did not exert any effect on prothrombin time and activated partial thromboplastin time. RGE-treated mice showed significantly better survival under thrombosis than FRG-treated mice, with no effects on hemostasis, whereas FRG-treated mice exhibited a slight increment in bleeding time. Conclusion: Both extracts, especially RGE, are remarkable supplements to maintain cardiovascular health and are potential candidates for the treatment and prevention of platelet-related cardiovascular disorders.