• Title/Summary/Keyword: intravascular

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Effects of Silsosangami-extract and Its Seven Herbs on Endotoxin-induced Experimental Thrombosis in Rats

  • Ahan, Jong-Chan;Kim, Jae-Woo;Park, Won-Hwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.1
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    • pp.218-223
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    • 2005
  • According to the Chinese and Korean medicinal and herbal literature, SSG(Silsosangami) is effective for the treatment of inflammation, hyperlipemia and arteriosclerosis. The pharmacological action of SSG has been limitedly studied in regard to ischemic infarction. This herbal medicine has been shown to express diverse activities such as immunomodulating, anti-infarction, anti-allergic and anti-inflammatory effects. Antisclerotic effects of SSG in experimentally induced atherosclerosis in rabbits have also been reported. However, pharmacological mechanisms of SSG on lipid metabolism and atherosclerosis formation are poorly understood. The present paper reports the effect of extracts obtained from SSG on endotoxin-induced experimental DIC in rats. Also, these were tested for their effect on endotoxin-induced blood platelet aggregation, thrombin-induced conversion of fibrinogen and fibrinolysis in vitro experiments with aspirin as a positive agent. The anti-thrombic properties of SSG were also investigated by means of analytical parameters of bood composition. The extracts of SSG and its seven herbs, except Cnidii Rhizoma and Carthami Flos, inhibited the endotoxin-induced DIC and thrombosis in rats. Also the extract inhibited the endotoxin-induced decrease in blood platelets and fibrinogen, and endotoxin-induced increase in fibrin degradation products (FDP) on disseminated intravascular coagulation in normal rats.

An Analysis of the Contrast Patterns of Lumbar Transforaminal Epidural Injection (요추 경추간공 경막외강 약물주입 시 조영상의 분석)

  • Kim, Sae Young;Han, Kyung Ream;Kim, Chan
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.217-223
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    • 2008
  • Background: Lumbar transforaminal epidural injections (LTEIs) have been utilized in the treatment of radicular pain, and LTEIs have the advantage of target-specificity. However, there have not been enough studies on the contrast patterns in LTEIs with using fluoroscopy. The purpose of this study was to evaluate the spreading epidural contrast patterns that are seen during real-time fluoroscopic guided LTEIs. Methods: A total of 131 patients who underwent fluoroscopic guided LTEIs were studied. The inclusion criteria were those patients with low back pain and/or lower extremity pain that was caused by a herniated nucleus pulposus, lumbar spinal stenosis, failed back surgery syndrome, and herpes zoster-associated pain. We classified the contrast patterns in regard to the contrast flow spreading to the nerve root and/or the unilateral, bilateral or cylinderic type of epidural spreading on the AP view of the fluoroscopy and the ventral or dorsal epidural filling on the lateral view. In addition to the pattern analysis, we evaluated the range of contrast spreading from the cranial to the caudal epidural filling and the incidence of an intravascular flow pattern. Results: Epidural spreading was seen in 126 cases (96.2%) of the total patients through the nerve root. Ventral spreading occurred in 120 cases (95.2%). On the AP view, a nerve root with unilateral, bilateral and cylinderic epidural filling was noted for 108 (85.7%), 9 (7.1%) and 9 (7.1%) cases, respectively. The contrast spreading to vertebral segments was smaller for the patients with lumbar spinal stenosis and failed back surgery syndrome than for the other groups (P < 0.0083). The incidence of intravascular injection was 11.1% (14/126). Conclusions: LTEIs using fluoroscopic visualization provided excellent assessment of the ventral epidural filling as well as nerve root filling. However, unilateral epidural spreading was prominent for the LTEIs.

Transcatheter Intravascular Stent Placement in a Shih Tzu Dog with Refractory Pulmonic Stenosis (카테터를 통한 혈관스텐트 장착을 통한 심한 폐동맥협착증 치료 1례)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Lee, Joon-Soek;Nam, So-Jeong;Choi, Ran;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.48-53
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    • 2009
  • A 4-year-old intact male Shih Tzu dog (5.4 kg of body weight) was referred with primary complaints of heart murmur and exercise intolerance. Diagnostic studies found severe valvular pulmonic stenosis (peak velocity of 6.4 m/s, pressure gradient 165 mmHg). The dog was treated with 3 cm (length) ${\times}$ 1.5 cm (diameter) of Palmaz biliary stent. The outcome of stent placement was favorable and remarkably reduced the severity of PS (6.4 m/s to 3.0 m/s of peak velocity). Clinical condition was remarkably improved with the absence of cardiac murmur, although mild pulmonic regurgitation existed from the day of stent placement. To our best knowledge, this case is the first clinical trial for treating PS with intravascular stent in Korea.

Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation (살모사 교상 후 발생한 범발성 혈관내 응고장애 2례)

  • Kim, Suk-Hwan;Choi, Se-Min;Oh, Young-Min;Park, Kyu-Nam;Lee, Won-Jae;Choi, Kyung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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A Case of Spindle Cell Hemangioendothelioma Involving the Lung, Mediastinum and Brain (폐, 종격동 및 뇌를 침범한 방추세포형 혈관내피종 1예)

  • Kim, Hwan-Tae;Kim, In-Ho;Lee, Bong-Choon;Kang, Chang-Il;Yoon, Hye-Kyoung
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.301-307
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    • 1993
  • Intravascular bronchioloalveolar tumor is now recognized as a pulmonary form of hemangioendothelioma(HE). HE is an unusual tumor of adult life which is characterized by proliferation of an "epithelioid" or "spindle" endothelial cell. In the lung it usually presents as multiple bilateral slowly growing nodules less than 2 cm in diameter. The aetiology and pathogenesis of this disease are unknown. Spindle cell HE occurs at any age, but approximately one half of patient are 25 years of age or younger and males are affected twice more frequently than females. On light microscopic examination, the tumor show mild cellular atypia, nearly absent mitoses and electron-microscopic studies reveal evidence of endothelial cell differentiation. Intracytoplasmic localization of Factor VIII-related antigen is demonstrated on immunohistochemical study, which confirmed the endothelial origin of the tumor. No effective therapy is yet known for HE, but survival of this tumor can be quite long. However, one half of the patient have died, usually of progressive pulmonary insufficiency. This 19-yr-old male complained of Rt. chest pain and intermittent hemoptysis. Simple chest film and chest CT scan showed the Rt. pleural effusion, variable sized bilateral pulmonary nodules, irregular large heterogenous tumor with well enhancement and extensive necrosis in the anterior mediastinum. The mediastinal mass was biopsied and diagnosed as spindle cell HE by light microscopic finding and immunohistochemical studies.

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A Case of Idiopathic Hypereosinophilic Syndrome Complicated with Pulmonary Thromboembolism and Disseminated Intravascular Coagulation (폐색전증과 파종성혈관내응고가 합병된 특발성 과호산구 증후군 1례)

  • Lee, Jong Sung;Lee, Hyun-Kyung;Lee, Sung Soon;Jin, Jae Yong;Lee, Young Min;Lee, Hyuk Pyo;Kim, Joo In;Ku, Bon Il;Choi, Soo Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.573-578
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    • 2004
  • The idiopathic hypereosinophilic syndrome (HES) comprises a heterogeneous group of disorders with unknown pathogenesis characterized by persistent peripheral blood and bone marrow eosinophilia. And the eosinophil infiltrates of multiple organs in HES lead to severe organ dysfunction. The disseminated intravascular coagulation (DIC) is a rare complication of HES. We have experienced a case of HES complicated with DIC and pulmonary thromboembolism. After intravenous injection of methylprednisone, blood eosinophil count was normalized but DIC was persisted. With cortico steroid and cyclosporine therapy, the disease activity was favorably remitted.

Nurses' Knowledge and Performance for the Prevention of Intravascular Catheter-related Infections according to the Strength of Recommendations of Evidence based Guidelines (정맥관 감염예방 근거중심 가이드라인의 권고강도 별 간호사의 지식 및 수행정도)

  • Ryu, Se-Ang;Kim, Yun-Hee;Jang, Keum-Seong;Chung, Kyung-Hee;Choi, Ja-Yun;Yang, Jin-Ju;Park, Soon-Joo
    • Korean Journal of Adult Nursing
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    • v.24 no.5
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    • pp.546-555
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    • 2012
  • Purpose: The objective of this study was to examine the relationships between nurses' knowledge and performance for the prevention of intravascular catheter-related infections (ICRI) according to the strength of recommendations in evidence based guidelines (EBG). Methods: The total participants were 144 nurses working for medical surgical unit and intensive care unit. Data were collected from July 12 to July 30, 2010 and analyzed by one way ANOVA and Pearson's correlation analysis. Results: The knowledge and performance mean scores were $0.80{\pm}0.17$ and $3.04{\pm}0.31$ for peripheral venous catheter (PVC) management, and $0.83{\pm}0.17$ and $3.00{\pm}0.30$ for central venous catheter (CVC) management respectively. The items of category IA had the highest knowledge score (F=44.70, p<.001) and the items of category II had the highest performance score (F=47.09, p<.001) in PVC management, while the items of category IA had the highest knowledge (F=20.04, p<.001) and performance scores (F=18.20, p<.001) in CVC management. Knowledge and performance scores were significantly correlated in CVC management (r=.24, p=.004), but not in PVC management (r=.03, p=.753). Conclusion: EBG for the prevention of ICRI was not fully implemented in clinical settings. These findings emphasize that clinical professions need to develope strategies to enhance nursing practices with evidence based guideline.

The Effect of Woohwangcheongsim-won on Circulatory Disturbance in Diabetes (우황청심원이 당뇨병 Rat의 혈액순환장애에 미치는 영향)

  • 황성록;정승현;신길조;이원철
    • The Journal of Korean Medicine
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    • v.23 no.2
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    • pp.164-179
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    • 2002
  • Object: Death rate due to hypertension, atherosclerosis, ischemic heart disease and cerebral infarction induced by Westernized diet and increased average life span is on the rise. Decrease in blood circulation, activation of thrombus generation and intravascular lipid accumulation, cited as the principal causes of the above mentioned diseases in recent studies, result in circulatory disturbance and blood vessel obstruction leading to ischemic cell death of heart, brain and peripheral vessels. Method: We investigated the biochemical changes in microvascular permeability, aggregation of platelet and the intravascular lipid accumulation in induced-diabetic rat using Streptozotocin. We also studied the effects of Woohwangcheongsirn-won after oral administration on blood circulation, platelet function and lipid metabolism. The results are as follows: I. Woohwangcheongsim-won increased blood circulation in microvessels. 2. Woohwangcheongsim-won increased the reduced erythrocyte deformability in diabetes. 3. Woohwangcheongsim-won induced the reduction of contents of 2, 3-DPG, but failed to affect the reduced contents of ATP in erythrocyte in diabetes. 4. Woohwangcheongsim-won reduced the activity of Ca/sup 2+/-ATPase in the membrane of erythrocyte. 5. Woohwangcheongsim-won reduced the platelet aggregation evoked by platelet agglutinin factor. 6. Woohwangcheongsim-won reduced the production of platelet-derived granules. 7. Woohwangcheongsim-won reduced the production of metabolites of arachidonic acid in diabetes, and also reduced the production of increased thromboxane B2. 8. Woohwangcheongsim-won reduced the synthesis of oxidized LDL-cholesterol. In conclusion, Woohwangcheongsim-won enhanced blood circulation in microvesseles, erythrocyte deformability and inhibited the increased platelet aggregation and the synthesis of oxidized LDL-cholesterol in diabetes. Therefore Woohwangcheongsim-won is believed to positively affect blood circulation (J Korean Oriental Med 2002;23(2):164-179)

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Transposition of Intravascular Lipid in Experimentally Induced Fat Embolism: A Preliminary Study

  • Hwang, So-Min;Lee, Jong-Seo;Kim, Hong-Il;Jung, Yong-Hui;Kim, Hyung-Do
    • Archives of Plastic Surgery
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    • v.41 no.4
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    • pp.325-329
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    • 2014
  • Background Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles. Methods A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain. Results Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area. Conclusions Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake.

A Case of Diffuse Alveolar Hemorrhage Complicated by HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelets) Syndrome (HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome에 합병된 미만성 폐포출혈 1예)

  • Jeong, Woo Jin;Huh, Jin Won;Yu, Mi Hyun;Choi, Young Jun;Jeon, Min Hyok;Sim, Jae Yun;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.418-422
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    • 2005
  • A diffuse alveolar hemorrhage (DAH) is a distinct form of pulmonary hemorrhage that originates from the pulmonary microcirculation. Disseminated intravascular coagulation (DIC) is one cause of DAH. Although HELLP syndrome associated with DIC can cause DAH, there are no published case reports that the authors are aware of. We report the case of a pregnant woman with HELLP syndrome who developed DAH. Because pregnant women with HELLP syndrome can develop DAH as a form of ARDS, a bronchoalveolar lavage may be used to make a differential diagnosis of this lung manifestation.