• Title/Summary/Keyword: heparin

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Effect of warfarin discontinuation on the incidence of postoperative bleeding in tooth extraction

  • Lee, Jung-Soo;Kim, Moon-Key;Kang, Sang-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.4
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    • pp.228-234
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    • 2020
  • Objectives: The number of patients undergoing oral anticoagulant therapy for cardiovascular and cerebrovascular disease is increasing. However, the risk of bleeding after tooth extraction in patients receiving warfarin is unclear. Here, we assess the risk of bleeding after tooth extraction in patients on warfarin. Materials and Methods: The study included 260 patients taking warfarin who underwent tooth extraction (694 teeth). The patients were divided into those whose teeth were extracted while they were taking warfarin, those who discontinued warfarin before extraction, and those who underwent extraction while receiving heparin bridging therapy. Bleeding complications in the two groups were compared. Results: Of the 260 patients, 156 underwent extraction while taking warfarin, 70 stopped taking warfarin before extractions, and 34 received heparin bridging therapy and stopped taking either medication before extractions. Bleeding complications occurred in 9 patients (3.5%) and 9 tooth sites (1.3%). Among the 9 patients with bleeding complications, 6 underwent extraction while taking warfarin, 2 stopped warfarin before extraction, and 1 underwent extraction after receiving heparin bridging therapy. No significant difference was seen between patient groups regarding bleeding after extractions (P=0.917). Conclusion: Warfarin use does not increase the risk of post-extraction bleeding and can therefore be continued during tooth extraction.

Design and decoration of heparin on porous nanosilica via reversible disulfide linkages for controlled drug release

  • Nguyen, Dai Hai
    • Journal of IKEEE
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    • v.21 no.3
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    • pp.320-330
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    • 2017
  • Porous nanosilica (PNS) has been identified as a potential candidate for controlled drug delivery. However, unmodified PNS-based carriers exhibited an initial release of loaded bioactive agents, which may limit their potential clinical applications. In this study, the surface of PNS was functionalized with adamantylamine (ADA) via disulfide bonds (-S-S-), PNS-S-S-ADA, which was then modified with cyclodextrin (CD)-heparin (Hep) (CD-Hep), PNS-S-S-CDH, for redox triggered rhodamine B (RhB) delivery. The obtained samples were then characterized by proton nuclear magnetic resonance ($^{1}H\;NMR$), Fourier transform infrared (FTIR), and transmission electron microscope (TEM). These results showed that PNS-S-S-CDH was successfully formed with spherical shape and average diameter of $45.64{\pm}2.33nm$. In addition, RhB was relatively encapsulated in the PNS-S-S-CDH (RhB@PNS-S-S-CDH) and slowly released up to 3 days. The release of RhB, in particular, was triggered due to the cleavage of -S-S- in the presence of dithiothreitol (DTT). It might be anticipated that the modified PNS can be used as redox-responsive drug delivery system in cancer therapy.

Enoxaparin as an Anticoagulant in a Multipara with a Mechanical Mitral Valve: A Case Report

  • Yo Seb Lee;Jun Seok Kim
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.452-455
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    • 2023
  • Patients who have undergone mechanical valve replacement require anticoagulation therapy with warfarin to prevent thromboembolism. However, administering warfarin to pregnant patients increases their risk of warfarin embryopathy or central nervous system disorders. Consequently, safer alternatives, such as heparin or low-molecular-weight heparin injection, are substituted for warfarin. However, limited research has been conducted on this subject, with no large-scale studies and particularly few investigations involving multiparous patients. A patient who had previously undergone mechanical mitral valve replacement for atrial septal defect and mitral stenosis received anticoagulant therapy with enoxaparin during 2 pregnancies. Upon confirmation of pregnancy, warfarin was replaced with subcutaneously injected enoxaparin with a dosage of 1 mg/kg at 12-hour intervals. The enoxaparin dosage was controlled using an anti-factor Xa assay, with a target range of 0.3-0.7 IU/mL. Intravenous heparin injections were administered starting 3 days prior to the expected delivery date and were continued until delivery, after which warfarin was resumed. No complications were observed during the deliveries.

Efficacy of 1:1000 Diluted Heparin versus 0.9% Normal Saline for Maintenance of Intermittent Intravenous Locks (희석된 헤파린과 생리식염수가 간헐적 말초정맥장치의 폐색, 유지기간 및 정맥염 발생에 미치는 영향)

  • Park Mi-Mi;Kim Chang-Hee;Cho Eun-Suk;Lee Mi-Jung;Kim Hae-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.208-221
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    • 2000
  • The objective of this research was to compare the flushing effects using 1:1,000 diluted heparin or 0.9% normal saline in relation to needle gauge and frequency of IV medications. The comparative categories were clotting, duration of patency, and incidence of phlebitis. The design of research was a Nonequivalent Control group, Post test, Nonsynchrorized Design. The independent variable was 0.9% normal saline flushing the IV locks and the dependent variables were clotting, duration of patency, and incidence of phlebitis. Subjects were medical-surgical inpatients over 15 years old and with peripherally placed IVs who were hospitalized in a university medical center. Exclusion criteria included foreigners and those who were rejected for this research. The final sample for data analysis included 295 IV sites in 194 patients; 154 were in the saline group and 141 were in the heparin group. Subjects were assigned to have IV locks is flushed with 0.9% normal saline in the experimental group and to have IV lock flushed with 1:1,000 diluted heparin(100 units) in the control group. In order to increase reliability, the nurses who were assigned to the units involved in the study received an explanation on the standard method for locking an IV, recording method for observational data and criteria for the detection of phlebitis. Data were collected for a period of 2 weeks, from March 16, 2000 to March 29, 2000. Total duration of IV was defined the time of IV insertion to the time of discontinuation. Phlebitis was defined as the presence of the following : pain, swelling. erythema at the insertion site. Chi-square was used to determine the association between the degree of clotting, duration of patency, and incidence of phlebitis for the diluted heparin or the normal saline and needle gauge and frequency of IV medications. The results are summarized as follows : (a) There was difference in the degree of clotting between two groups($X^2=5.882$, p=.015). (b) There was no difference in the degree of duration of patency between two groups($X^2=2.439$, p=.295). (c) There was no difference in the incidence of phlebitis between two groups($X^2=0.190$, p=.663). (d) There was difference in the degree of clotting($X^2=6.209$, p=.013) and in the degree of duration of patency($X^2=6.978$, p=.031) according the needle guage between the two groups. (e) There was difference in the incidence of phlebitis($X^2=5.008$, p=.025) according to the frequencies of IV injection between two groups.

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The effect of immobilization of heparin and bone morphogenic protein-2 to bovine bone substitute on osteoblast-like cell's function

  • Huh, Jung-Bo;Kim, Sung-Eun;Song, Se-Kyung;Yun, Mi-Jung;Shim, Ji-Suk;Lee, Jeong-Yo;Shin, Sang-Wan
    • The Journal of Advanced Prosthodontics
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    • v.3 no.3
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    • pp.145-151
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    • 2011
  • PURPOSE. This study was performed to investigate the ability of recombinant human-bone morphogenic protein-2 immobilized on a heparin-grafted bone substrate to enhance the osteoblastic functions. MATERIALS AND METHODS. The Bio-$Oss^{(R)}$, not coated with any material, was used as a control group. In rhBMP-2-Bio-$Oss^{(R)}$ group, rhBMP-2 was coated with Bio-$Oss^{(R)}$ using only deep and dry methods (50 ng/mL, 24 h). In heparinized rhBMP-2-Bio-$Oss^{(R)}$ group, dopamine was anchored to the surface of Bio-$Oss^{(R)}$, and coated with heparin. rhBMP-2 was immobilized onto the heparinized- Bio-$Oss^{(R)}$ surface. The release kinetics of the rhBMP-2-Bio-$Oss^{(R)}$ and heparinized rhBMP-2-Bio-$Oss^{(R)}$ were analyzed using an enzyme-linked immunosorbent assay. The biological activities of the MG63 cells on the three groups were investigated via cytotoxicity assay, cell proliferation assay, alkaline phosphatase (ALP) measurement, and calcium deposition determination. Statistical comparisons were carried out by one-way ANOVA test. Differences were considered statistically significant at $^*$P<.05 and $^{**}$P<.001. RESULTS. The heparinized rhBMP-2-Bio-$Oss^{(R)}$ showed more sustained release compared to the rhBMP-2-Bio-$Oss^{(R)}$ over an extended time. In the measurement of the ALP activity, the heparinized group showed a significantly higher ALP activity when compared with the non-heparinized groups (P<.05). The MG63 cells cultivated in the group with rhBMP-2 showed increased calcium deposition, and the MG63 cells from the heparinized group increased more than those that were cultivated in the non-heparinized groups. CONCLUSION. Heparin increased the rhBMP-2 release amount and made sustained release possible, and heparinized Bio-$Oss^{(R)}$ with rhBMP-2 successfully improved the osteoblastic functions.

Relationship between the mRNA Expression Levels of Sperm Phospholipids Hydroperoxide Glutathione Peroxidase and Heparin-Binding Protein, and in-Vivo Fertility in Boars (돼지 정자내 Phospholipids Hydroperoxide Glutathione Peroxidase와 Heparin-Binding Protein의 발현 수준과 번식 능력의 관계)

  • Oh, Shin-Ae;Shin, Cha-Gyun;You, Young-Ah;Han, Kyung-Soo;Pang, Myung-Geol
    • Reproductive and Developmental Biology
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    • v.31 no.3
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    • pp.133-137
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    • 2007
  • The objective of the study was to determine the relationship between the mRNA expression levels of sperm phospholipids hydroperoxide glutathione peroxidase (PHGPx) and heparin-binding protein (HBP), and in-vivo fertility in boars. The farrowing rate was not correlated with litter size. Sperm PHGPx mRNA expression level of the larger litter size (over 10) group $(2,414.7{\pm}400.7)$ was high that of smaller litter size (below 8) group $(1,875.8{\pm}311.2)$. Sperm HBP mRNA expression level was also higher in the larger litter size $(2,255.9{\pm}360.8)$ group than the smaller litter size $(2,155.4{\pm}378.0)$. However, significant differences were not observed. Sperm PHGPx mRNA level was correlated positively with litter size (r=0.206). Because the expression levels of PHGPx and HBP are not strongly correlated with in-vivo fertility, PHGPx and HBP can not be considered a predictive measure for fertility in boars.

EFFECT OF ARTERIAL REPAIR AND PATENCY AFTER MICROVASCULAR ANASTOMOSIS WITH TOPICAL IRRIGATION OF VARIOUS ANTI-THROMBUS DRUGS (수종의 항혈전제의 국소 세척이 미세혈관문합의 동맥 치유 및 개존에 미치는 영향)

  • Choi, Yong-Chul;Kim, Kyung-Wook;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.117-128
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    • 2006
  • Free flap transplantation with microvascular anastomosis has been successfully performed by development of surgical technique, materials and postoperative monitoring equipments of flap. But success rate of microvascular anastomosis is influenced by various factors, and failure rate is about 5-10%. The most influential factor for success rate is surgical technique and other factors that influence failure of microvascular anastomosis are ischemic time of free flap, thrombus formation of anastomosis region and vascular spasm. Many studies has been published in microvascular anastomosis with histologic effect for irrigating solution. But local irrigation solution has been used clinically in microvascular anastomosis, the comparison with each solution, microhistological study for endothelial cell repair and vascular patency has not been reported. The heparin which is anti-thrombotic agent, and urokinase which is fibrinolytic agent are used for this study. Vascular patency and thrombus formation in experimental micro-arterial anastomosis, and endothelial repair were observed with histologic analysis, scanning electron microscopy, transmission electron microscopic examination. The results were obtained as follows: 1. In vascular patency test in 30 minute and 7 days after micro-arterial anastomosis, equal effects of good vascular patency were obtained in group of local irrigation with heparin and urokinase. 2. In thrombus formation in 7 days after micro-arterial anastomosis, equal effects of minimal thrombus formation were obtained in group of local irrigation with heparin and urokinase. 3. In toluidin blue staining in 7 days after micro-arterial anastomosis, local destruction of endothelial cell and inner elastic lamina were seen and endothelial repair was not seen. 4. In scanning electron microscope examination in 7 days after micro-arterial anastomosis, endothelial cell was not seen in peripheral to suture materials, thrombus associated fibrin network was observed. 5. In transmission electron microscope examination in 7 days after micro-arterial anastomosis, inflammatory cell was seen within smooth muscle cells in site of endothelial cell destruction, smooth muscle cell around suture material were arranged irregularly, some collagenous change were seen. From the results obtained in this study, same results of good vascular patency and anti-thrombotic effect of heparin and urokinase were obtained as a local irrigation solution, and repair of endothelial cell was not seen in 7 days after micro-arterial anastomosis.

Effect of cell morphology on the hepatic functions adult rat hepatocytes (세포형태에 따른 쥐 간세포의 분화기능)

  • 이재호;박정극최태부
    • KSBB Journal
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    • v.7 no.4
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    • pp.278-283
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    • 1992
  • Rat hepatocytes were isolated and cultured on the petri dishes treated with various coating materials. Untreated or collagen coated petri dish gave monolayer culture of hepatocyte and proteoglycan, dermatan sulfate, and BSA treated petri dish gave hemispheroid. The untreated Primaria petri dish gave spheroid type of hepatocyte, and heparin and hyaluronic acid treatment gave multilayers. To sustain high cell viability, monolayer cultured hepatocytes was more useful, while it was found that the hemispheroid or spheroid type hepatocytes was more active in the hepatic functions such as ammonia metabolism and albumin synthesis.

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